Provider Demographics
NPI:1992040661
Name:SHARP, DEENA SHEILA
Entity Type:Individual
Prefix:MS
First Name:DEENA
Middle Name:SHEILA
Last Name:SHARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 OWENSMOUTH AVE
Mailing Address - Street 2:FL 10 DIRECTED SPECIALIZED SERVICES
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367
Mailing Address - Country:US
Mailing Address - Phone:323-391-1622
Mailing Address - Fax:323-391-1622
Practice Address - Street 1:6303 OWENSMOUTH AVE
Practice Address - Street 2:FL 10
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2264
Practice Address - Country:US
Practice Address - Phone:323-391-1622
Practice Address - Fax:323-391-1622
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 1468235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist