Healthcare Provider Details

I. General information

NPI: 1902739725
Provider Name (Legal Business Name): SHARINA KRISTEL VELASCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 W BALL RD STE 4A
ANAHEIM CA
92804-5589
US

IV. Provider business mailing address

812 ANTOINETTE LN APT E
SOUTH SAN FRANCISCO CA
94080-3325
US

V. Phone/Fax

Practice location:
  • Phone: 714-257-5534
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: