Provider Demographics
NPI:1952343626
Name:BJORNSON, SHARON (MFT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BJORNSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 MOUNTAIN BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2827
Mailing Address - Country:US
Mailing Address - Phone:510-339-7707
Mailing Address - Fax:510-451-0460
Practice Address - Street 1:2080 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2827
Practice Address - Country:US
Practice Address - Phone:510-339-7707
Practice Address - Fax:510-451-0460
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22758106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC22758OtherMFT LICENSE #