Individual
LONNEKA SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 E GILBERT ST, SAN BERNARDINO, CA 92415-1319
(909) 387-7200
Mailing address
15040 KITFOX LN, VICTORVILLE, CA 92394-7489
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95093817A45098
MEDI-CAL
—
Enumeration date
10/18/2022
Last updated
04/09/2025
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