Provider Demographics
NPI:1811310188
Name:SHARPE, JENNIFER LYNN (MA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:SHARPE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 CHURCH ST.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114
Mailing Address - Country:US
Mailing Address - Phone:415-747-7327
Mailing Address - Fax:650-366-0220
Practice Address - Street 1:126 CHURCH ST.
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114
Practice Address - Country:US
Practice Address - Phone:415-747-7327
Practice Address - Fax:650-366-0220
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71672101YM0800X
CA86384106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health