Provider Demographics
NPI:1467446419
Name:KAZ, SHARON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:KAZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15515 DEL GADO DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-4204
Mailing Address - Country:US
Mailing Address - Phone:818-788-1040
Mailing Address - Fax:818-501-2006
Practice Address - Street 1:15515 DEL GADO DR
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-4204
Practice Address - Country:US
Practice Address - Phone:818-788-1040
Practice Address - Fax:818-501-2006
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS98171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS9817OtherLICENSE NUMBER