Basic Information
| Provider Information | |||||||||
| NPI: | 1235220831 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERSTEIN | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N MAIN ST | ||||||||
| Address2: | 100-B | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927013640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144806650 | ||||||||
| FaxNumber: | 7145715659 | ||||||||
| Practice Location | |||||||||
| Address1: | 218 W MAIN ST | ||||||||
| Address2: | 202 | ||||||||
| City: | TUSTIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927807719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145204894 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | MFC25957 | CA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.