Provider Demographics
NPI:1417324401
Name:SHARMA, SAHIL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SAHIL
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 COLLEGE AVE STE 318A
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1672
Mailing Address - Country:US
Mailing Address - Phone:510-545-3306
Mailing Address - Fax:
Practice Address - Street 1:5655 COLLEGE AVE STE 318A
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1672
Practice Address - Country:US
Practice Address - Phone:510-545-3306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33606103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program