Provider Demographics
NPI:1598969032
Name:TALOVIC, SHARON ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ANN
Last Name:TALOVIC
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 1:23812 HARBOR VISTA DR
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-4819
Mailing Address - Country:US
Mailing Address - Phone:310-456-7230
Mailing Address - Fax:310-456-7295
Practice Address - Street 1:23812 HARBOR VISTA DR
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4819
Practice Address - Country:US
Practice Address - Phone:310-456-7230
Practice Address - Fax:310-456-7295
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY096740OtherMEDI-CAL
CAPSY096740OtherMEDI-CAL