Provider Demographics
NPI:1053624882
Name:DI PIRRO-BEARD, SHARON LEE (RD,LMFT)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEE
Last Name:DI PIRRO-BEARD
Suffix:
Gender:F
Credentials:RD,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5870 MACARGO ST
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-9466
Mailing Address - Country:US
Mailing Address - Phone:916-595-1956
Mailing Address - Fax:916-791-3356
Practice Address - Street 1:5870 MACARGO ST
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-9466
Practice Address - Country:US
Practice Address - Phone:916-595-1956
Practice Address - Fax:916-791-3356
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 28371101Y00000X
CA608523133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered