Provider Demographics
NPI:1457829095
Name:DRIESSEN, SHARON (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:DRIESSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 COCA
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-1718
Mailing Address - Country:US
Mailing Address - Phone:949-374-0193
Mailing Address - Fax:
Practice Address - Street 1:16 COCA
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1718
Practice Address - Country:US
Practice Address - Phone:949-374-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical