Provider Demographics
NPI:1912199530
Name:IHLEFELD, SHARON M (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:IHLEFELD
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 1:433 1/2 LELAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2332
Mailing Address - Country:US
Mailing Address - Phone:408-561-8041
Mailing Address - Fax:408-358-9299
Practice Address - Street 1:15545 LOS GATOS BLVD
Practice Address - Street 2:B
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2567
Practice Address - Country:US
Practice Address - Phone:408-358-9800
Practice Address - Fax:408-358-9299
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor