Provider Demographics
NPI:1801088364
Name:LEYDEN, SHARON HAWKINS
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:HAWKINS
Last Name:LEYDEN
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 1:1744 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1514
Mailing Address - Country:US
Mailing Address - Phone:510-704-9867
Mailing Address - Fax:510-848-1456
Practice Address - Street 1:1744 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-1514
Practice Address - Country:US
Practice Address - Phone:510-704-9867
Practice Address - Fax:510-848-1456
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS213071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical