Provider Demographics
NPI:1801398540
Name:LAU, SHARON S
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:S
Last Name:LAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:SO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2259 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-2813
Mailing Address - Country:US
Mailing Address - Phone:650-238-4668
Mailing Address - Fax:
Practice Address - Street 1:20111 STEVENS CREEK BLVD STE 145
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2345
Practice Address - Country:US
Practice Address - Phone:408-366-1098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist