Provider Demographics
NPI:1598134678
Name:SHARP, AMY K (PHD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:SHARP
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 1:9615 MCANARLIN AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:CA
Mailing Address - Zip Code:95938-9613
Mailing Address - Country:US
Mailing Address - Phone:650-996-7684
Mailing Address - Fax:
Practice Address - Street 1:4370 ALPINE RD STE 200
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7953
Practice Address - Country:US
Practice Address - Phone:650-422-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27358103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical