Basic Information
Provider Information
NPI: 1841427895
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELKINS
FirstName: SHARON
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 235 N 3RD ST
Address2:  
City: CAMPBELL
State: CA
PostalCode: 950082002
CountryCode: US
TelephoneNumber: 4156370027
FaxNumber:  
Practice Location
Address1: 2001 THE ALAMEDA
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951261136
CountryCode: US
TelephoneNumber: 4082617777
FaxNumber: 4082549960
Other Information
ProviderEnumerationDate: 06/17/2009
LastUpdateDate: 06/17/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X53058CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


Home