Provider Demographics
NPI:1871843367
Name:HARVEY, SHARLA R (MS, CCC)
Entity Type:Individual
Prefix:
First Name:SHARLA
Middle Name:R
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 LOS CERRITOS LN
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2605
Mailing Address - Country:US
Mailing Address - Phone:858-705-7741
Mailing Address - Fax:
Practice Address - Street 1:11590 W BERNARDO CT
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1622
Practice Address - Country:US
Practice Address - Phone:858-432-4749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist