Provider Demographics
NPI:1881846657
Name:CHAPMAN, SHARON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:HUDES
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:8300 S VERMONT AVE
Mailing Address - Street 2:WOMEN'S REINTEGRATION CENTER
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-3422
Mailing Address - Country:US
Mailing Address - Phone:323-525-6431
Mailing Address - Fax:
Practice Address - Street 1:8300 S VERMONT AVE
Practice Address - Street 2:WOMEN'S REINTEGRATION CENTER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-3422
Practice Address - Country:US
Practice Address - Phone:323-525-6431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CAPSY23332103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW2983BOtherMEDICARE GROUP
CAHD213ZMedicare PIN