Provider Demographics
NPI:1962930404
Name:POWERS, SHARON ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ELIZABETH
Last Name:POWERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:25131 DANAPEPPER
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3109
Mailing Address - Country:US
Mailing Address - Phone:949-466-2265
Mailing Address - Fax:949-916-5075
Practice Address - Street 1:28281 CROWN VALLEY PKWY STE 225
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1483
Practice Address - Country:US
Practice Address - Phone:949-466-2265
Practice Address - Fax:949-916-5075
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-29
Last Update Date:2017-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19203103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist