Provider Demographics
NPI:1750491544
Name:HILDERBRANT, SHARON DIANE (PSYD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DIANE
Last Name:HILDERBRANT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 W JEFFERSON AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235
Mailing Address - Country:US
Mailing Address - Phone:303-984-1095
Mailing Address - Fax:303-795-6076
Practice Address - Street 1:7220 W JEFFERSON AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235
Practice Address - Country:US
Practice Address - Phone:303-984-1095
Practice Address - Fax:303-795-6076
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2389103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
8992664OtherCIGNA
CO91531055Medicaid
COAMISR9906OtherANTHEM BCBS
8992664OtherCIGNA