Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | G70516 | CA |
NPI | 1003851015 |
---|---|
Provider Name | Sharon Denise Washington |
First Address | Tracy, CA 95376-3856 |
Second Address | Tracy, CA 95376-3856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 20/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H01608 | (02) | |
OOG705160 | (05) | CA |