Provider Demographics
NPI:1417070764
Name:COLOMBINI, SHARON A (MFT)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:A
Last Name:COLOMBINI
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 1:4535 MISSOURI FLAT RD STE C
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6846
Mailing Address - Country:US
Mailing Address - Phone:530-651-3203
Mailing Address - Fax:
Practice Address - Street 1:4535 MISSOURI FLAT RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6808
Practice Address - Country:US
Practice Address - Phone:530-651-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37729106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist