Provider Demographics
NPI:1386717270
Name:YOUNG, SHARON O'NAN (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:O'NAN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-2517
Mailing Address - Country:US
Mailing Address - Phone:619-584-1470
Mailing Address - Fax:619-584-1470
Practice Address - Street 1:4233 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-2517
Practice Address - Country:US
Practice Address - Phone:619-584-1470
Practice Address - Fax:619-584-1470
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4507103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY045070Medicaid
CAPSY045070Medicaid