Provider Demographics
NPI:1437289014
Name:SHARROCK, ERIC WILLIAM (MCJ)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:WILLIAM
Last Name:SHARROCK
Suffix:
Gender:M
Credentials:MCJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2832
Mailing Address - Country:US
Mailing Address - Phone:530-247-3301
Mailing Address - Fax:530-247-3323
Practice Address - Street 1:2400 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2832
Practice Address - Country:US
Practice Address - Phone:530-247-3301
Practice Address - Fax:530-247-3323
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health