Provider Demographics
NPI:1386978047
Name:RIPPNER, SHARON ANDERSON (PHD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ANDERSON
Last Name:RIPPNER
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:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:AVILA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93424-0246
Mailing Address - Country:US
Mailing Address - Phone:805-748-2844
Mailing Address - Fax:805-595-9629
Practice Address - Street 1:1521 HIGUERA ST
Practice Address - Street 2:SUITE E
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2958
Practice Address - Country:US
Practice Address - Phone:805-748-2844
Practice Address - Fax:805-595-9629
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6297103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical