Provider Demographics
NPI:1962654566
Name:SHARE, JOSEPH HYMAN (PHD CLINICAL PSYCH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:HYMAN
Last Name:SHARE
Suffix:
Gender:M
Credentials:PHD CLINICAL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77564 COUNTRY CLUB DR.
Mailing Address - Street 2:BUILDING B, SUITE 408
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-0484
Mailing Address - Country:US
Mailing Address - Phone:760-779-2082
Mailing Address - Fax:
Practice Address - Street 1:77564 COUNTRY CLUB DR.
Practice Address - Street 2:BUILDING B, SUITE 408
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-0484
Practice Address - Country:US
Practice Address - Phone:760-779-2082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8078103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical