Provider Demographics
NPI:1629313796
Name:DICKSON, SHARON LEA (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEA
Last Name:DICKSON
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LEA
Other - Last Name:TOMLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:2030 E 4TH ST
Mailing Address - Street 2:#158
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3940
Mailing Address - Country:US
Mailing Address - Phone:714-667-2342
Mailing Address - Fax:714-667-2345
Practice Address - Street 1:2030 E 4TH ST
Practice Address - Street 2:#158
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3940
Practice Address - Country:US
Practice Address - Phone:714-667-2342
Practice Address - Fax:714-667-2345
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 163241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical