Individual
SHARON RENEE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 379-4179
Mailing address
5100 VISTA GRANDE DR APT 1317, ANTIOCH, CA 94531-8547
(510) 379-4179
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40420
CA
Other
Enumeration date
10/30/2025
Last updated
10/31/2025
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