Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 8869 | CA |
NPI | 1083744296 |
---|---|
Provider Name | Sharleen Renee Herrera |
First Address | Aliso Viejo, CA 92656-8038 |
Second Address | Aliso Viejo, CA 92656-8038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 23/03/2010 |