Provider Demographics
NPI:1982479028
Name:LAMBERT, SHARI RAQIA (PPS)
Entity Type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:RAQIA
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7431 SHORELINE DR # 7431
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-4586
Mailing Address - Country:US
Mailing Address - Phone:209-346-2338
Mailing Address - Fax:
Practice Address - Street 1:632 W 11TH ST STE 119
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3860
Practice Address - Country:US
Practice Address - Phone:209-237-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230129571101YS0200X
CA10692355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool