Provider Demographics
NPI:1477635829
Name:UFBERG, SHARON (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:UFBERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 MANHATTAN AVE APT C
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-4153
Mailing Address - Country:US
Mailing Address - Phone:510-501-0753
Mailing Address - Fax:
Practice Address - Street 1:3816 WOODRUFF AVE STE 102
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2145
Practice Address - Country:US
Practice Address - Phone:510-501-0753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009987OtherLICENSE
CA14519OtherLICENSE