Provider Demographics
NPI:1245979624
Name:CHAVEZ-BURCIAGA, SHARON AMERICA (BT)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:AMERICA
Last Name:CHAVEZ-BURCIAGA
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 PALOMAR AIRPORT RD STE 350
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1451
Mailing Address - Country:US
Mailing Address - Phone:760-438-0078
Mailing Address - Fax:
Practice Address - Street 1:2141 PALOMAR AIRPORT RD STE 350
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1451
Practice Address - Country:US
Practice Address - Phone:760-438-0078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician