Provider Demographics
NPI:1346498128
Name:LOVESETH, SHARON LYNN (CADC I, SOMATIC EDUC)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LYNN
Last Name:LOVESETH
Suffix:
Gender:F
Credentials:CADC I, SOMATIC EDUC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608
Mailing Address - Country:US
Mailing Address - Phone:916-550-2501
Mailing Address - Fax:510-787-3116
Practice Address - Street 1:18 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:PORT COSTA
Practice Address - State:CA
Practice Address - Zip Code:94569-0223
Practice Address - Country:US
Practice Address - Phone:510-787-3486
Practice Address - Fax:510-787-3116
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACADC I 084397101YA0400X
CALCI03810315101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)