Provider Demographics
NPI:1326337197
Name:SHARER, DANIEL JAY (LMFT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAY
Last Name:SHARER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 TUXEDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1542
Mailing Address - Country:US
Mailing Address - Phone:949-500-2774
Mailing Address - Fax:619-403-9307
Practice Address - Street 1:6715 TUXEDO RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-1542
Practice Address - Country:US
Practice Address - Phone:949-500-2774
Practice Address - Fax:619-403-9307
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89691106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist