Provider Demographics
NPI:1366844243
Name:ROME, SHARON DENISE (PTA)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:DENISE
Last Name:ROME
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 SALTANA WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-3627
Mailing Address - Country:US
Mailing Address - Phone:719-310-8360
Mailing Address - Fax:
Practice Address - Street 1:5525 DEWEY DR
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3129
Practice Address - Country:US
Practice Address - Phone:916-536-9130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51552225200000X
CO13140225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant