Provider Demographics
NPI:1417067620
Name:SLOPER, SHARON GAIL (MFT)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:GAIL
Last Name:SLOPER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DOUGLAS BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4285
Mailing Address - Country:US
Mailing Address - Phone:916-789-9916
Mailing Address - Fax:916-749-4395
Practice Address - Street 1:3400 DOUGLAS BLVD STE 250
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-789-9916
Practice Address - Fax:916-749-4395
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTM15641106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist