Provider Demographics
NPI:1912878059
Name:MOLINA, SHARON MICHELLE
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:MICHELLE
Last Name:MOLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 WHITE OAK AVE
Mailing Address - Street 2:PO BOX #16573
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416
Mailing Address - Country:US
Mailing Address - Phone:714-398-8134
Mailing Address - Fax:
Practice Address - Street 1:969 COLORADO BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1715
Practice Address - Country:US
Practice Address - Phone:626-421-7960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health