Provider Demographics
NPI:1346473865
Name:NUNAN, SHARY ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARY
Middle Name:ANNE
Last Name:NUNAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GLEN EDEN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4316
Mailing Address - Country:US
Mailing Address - Phone:510-452-1660
Mailing Address - Fax:510-525-5508
Practice Address - Street 1:17 GLEN EDEN AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4316
Practice Address - Country:US
Practice Address - Phone:510-452-1660
Practice Address - Fax:510-525-5508
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 7267174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist