Provider Demographics
NPI:1619155256
Name:DOWNER, SHARON J (LISAC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:J
Last Name:DOWNER
Suffix:
Gender:F
Credentials:LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 W. SEEDFARM RD.
Mailing Address - Street 2:HU HU KAM MEMORIAL HOSPITAL
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85247-0038
Mailing Address - Country:US
Mailing Address - Phone:602-528-7175
Mailing Address - Fax:602-528-1374
Practice Address - Street 1:483 W. SEEDFARM RD.
Practice Address - Street 2:HU HU KAM MEMORIAL HOSPITAL
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85247-0038
Practice Address - Country:US
Practice Address - Phone:602-528-7175
Practice Address - Fax:602-528-1374
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-0942101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ346214Medicaid