Provider Demographics
NPI:1417410713
Name:CHEN, SHARON (DO)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19772 MACARTHUR BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2405
Mailing Address - Country:US
Mailing Address - Phone:949-304-6727
Mailing Address - Fax:
Practice Address - Street 1:19772 MACARTHUR BLVD STE 220
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2405
Practice Address - Country:US
Practice Address - Phone:949-304-6722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A194042084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry