Provider Demographics
NPI:1801991088
Name:WONDER, SHARON L Y (NP)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L Y
Last Name:WONDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:L
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-287-7532
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:430 N PALORA AVE
Practice Address - Street 2:SUITE G
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4707
Practice Address - Country:US
Practice Address - Phone:530-674-2603
Practice Address - Fax:530-674-0941
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 289217363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BH672ZMedicare PIN