Provider Demographics
NPI:1861717944
Name:SANDS, SHARON ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ANN
Last Name:SANDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95665-0444
Mailing Address - Country:US
Mailing Address - Phone:209-296-7949
Mailing Address - Fax:
Practice Address - Street 1:19881 HIGHWAY 88
Practice Address - Street 2:SUITE 6
Practice Address - City:PINE GROVE
Practice Address - State:CA
Practice Address - Zip Code:95665-8607
Practice Address - Country:US
Practice Address - Phone:209-304-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS197651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical