Individual provider Active NPI

Sharon Gardner, PSY.D.

  • Clinical Psychologist
  • Beverly Hills, CA
National Provider Identifier
1043312234
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19907 Issued in CA
Practice address
9777 Wilshire Blvd Ste 903
Beverly Hills, CA 90212-1902
Phone
(310) 710-0111
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT35000 CA
Clinical Psychologist 103TC0700X PSY19907 CA Primary

Addresses

Primary practice location

9777 Wilshire Blvd Ste 903
Beverly Hills, CA 90212-1902

Mailing address

9777 Wilshire Blvd Ste 903
Beverly Hills, CA 90212-1902
Phone (310) 710-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110325000688 CA Practitioner - Clinical Psychologist 9234312364 Practice locations: Beverly Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9777 Wilshire Blvd
Suite 903
Beverly Hills, CA 90212-1902
Phone (310) 710-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY19907CAMDClinical Psychologist
MFT35000CAMDMarriage & Family Therapist
19907CAMDDental Hygienist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1043312234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9777 WILSHIRE BLVD STE 903",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121902",
            "telephone_number": "310-710-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 WILSHIRE BLVD STE 903",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902121902",
            "telephone_number": "310-710-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT35000",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.