Provider Demographics
NPI:1043409808
Name:TREVORROW, SHARON MARIE (MFT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:TREVORROW
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6746
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95763-6746
Mailing Address - Country:US
Mailing Address - Phone:916-934-8162
Mailing Address - Fax:916-984-5697
Practice Address - Street 1:419 MASON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4546
Practice Address - Country:US
Practice Address - Phone:916-934-8162
Practice Address - Fax:916-984-5697
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist