Provider Demographics
NPI:1861497992
Name:DOLLASE, SHARON E (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:E
Last Name:DOLLASE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 WILLOW LN
Mailing Address - Street 2:STE122
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4941
Mailing Address - Country:US
Mailing Address - Phone:805-495-2127
Mailing Address - Fax:805-495-4946
Practice Address - Street 1:3180 WILLOW LN
Practice Address - Street 2:STE122
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-4941
Practice Address - Country:US
Practice Address - Phone:805-495-2127
Practice Address - Fax:805-495-4946
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU65846Medicare UPIN
CADC24737Medicare PIN