Provider Demographics
NPI:1376088658
Name:GRANDE, SHARI B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:B
Last Name:GRANDE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHARI
Other - Middle Name:ELLYN
Other - Last Name:BAUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3561 HOMESTEAD RD # 2500
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5161
Mailing Address - Country:US
Mailing Address - Phone:650-485-1036
Mailing Address - Fax:
Practice Address - Street 1:1127 LOCHINVAR AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-5102
Practice Address - Country:US
Practice Address - Phone:650-485-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA873091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376088658OtherNPI