Provider Demographics
NPI:1205177748
Name:O'CONNOR, SHARON MICHELE (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:MICHELE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 WOODLEY AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2721
Mailing Address - Country:US
Mailing Address - Phone:310-600-7214
Mailing Address - Fax:818-905-9181
Practice Address - Street 1:4505 WOODLEY AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2721
Practice Address - Country:US
Practice Address - Phone:310-600-7214
Practice Address - Fax:818-905-9181
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health