Provider Demographics
NPI:1275657520
Name:QUINN, SHARON (MA, MFT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 ECHO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRUNEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93907-8429
Mailing Address - Country:US
Mailing Address - Phone:831-663-5456
Mailing Address - Fax:831-663-6046
Practice Address - Street 1:910 MONTEREY ST
Practice Address - Street 2:#223
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-4637
Practice Address - Country:US
Practice Address - Phone:831-637-0112
Practice Address - Fax:831-663-6046
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist