Provider Demographics
NPI:1437502622
Name:FLYNN, SHARON F (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:F
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LEE
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3468 MT DIABLO BLVD STE B201
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3959
Mailing Address - Country:US
Mailing Address - Phone:510-621-7742
Mailing Address - Fax:
Practice Address - Street 1:3468 MT DIABLO BLVD STE B200
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-7102
Practice Address - Country:US
Practice Address - Phone:510-621-7742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-22
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123670106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program