Provider Demographics
NPI:1659407914
Name:GOLDFARB, SHARI R (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:R
Last Name:GOLDFARB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1792 TRIBUTE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4305
Mailing Address - Country:US
Mailing Address - Phone:916-924-6400
Mailing Address - Fax:916-648-0196
Practice Address - Street 1:3160 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5219
Practice Address - Country:US
Practice Address - Phone:916-733-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS143311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA257709OtherINTERPLAN
CA5685344OtherAETNA
CA2010024OtherPACIFICARE
CALCS14331OtherBLUE CROSS
CAMCMG381400OtherWESTERN HEALTH ADVANTAGE
CA000810837397OtherPHCS
CA1089911OtherGREAT WEST
CA5717751OtherFIRST HEALTH
CA2010024OtherPACIFICARE