Provider Demographics
NPI:1124344437
Name:BRYANT, SHARILEE ANN (MD)
Entity type:Individual
Prefix:
First Name:SHARILEE
Middle Name:ANN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 W HOSPITALITY LN STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-0026
Mailing Address - Country:US
Mailing Address - Phone:909-382-3105
Mailing Address - Fax:
Practice Address - Street 1:17216 SLOVER AVE
Practice Address - Street 2:STE L
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-7580
Practice Address - Country:US
Practice Address - Phone:909-854-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1190772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry