Provider Demographics
NPI:1629357850
Name:CLONTS, SHARRI LEE (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHARRI
Middle Name:LEE
Last Name:CLONTS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:SANTAQUIN
Mailing Address - State:UT
Mailing Address - Zip Code:84655-7182
Mailing Address - Country:US
Mailing Address - Phone:714-907-7519
Mailing Address - Fax:
Practice Address - Street 1:17350 MOUNT HERRMANN ST
Practice Address - Street 2:SUITE A
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4114
Practice Address - Country:US
Practice Address - Phone:714-444-3463
Practice Address - Fax:714-444-1768
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF62741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health