Provider Demographics
NPI:1225252075
Name:JONES, SHARRYN R (MSPT, CSCS)
Entity Type:Individual
Prefix:
First Name:SHARRYN
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:MSPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E 3RD AVE
Mailing Address - Street 2:#2807
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2166
Mailing Address - Country:US
Mailing Address - Phone:303-669-9829
Mailing Address - Fax:
Practice Address - Street 1:1600 E 3RD AVE
Practice Address - Street 2:#2807
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2166
Practice Address - Country:US
Practice Address - Phone:303-669-9829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27405174400000X
CO7218174400000X
FLPT19607174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist