Provider Demographics
NPI:1881126142
Name:LOVEJOY, SHARON ANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANNE
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ANNE
Other - Last Name:LOVEJOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:346 CORTE MADERA AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1383
Mailing Address - Country:US
Mailing Address - Phone:415-307-4869
Mailing Address - Fax:
Practice Address - Street 1:346 CORTE MADERA AVE APT 1A
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1383
Practice Address - Country:US
Practice Address - Phone:415-307-4869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist