Healthcare Provider Details

I. General information

NPI: 1033650007
Provider Name (Legal Business Name): DANIELLE SHARPSTENE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2017
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date: 07/04/2018
Reactivation Date: 11/19/2019

III. Provider practice location address

4300 LONG BEACH BLVD STE 700
LONG BEACH CA
90807-2000
US

IV. Provider business mailing address

1301 S KOKE MILL RD
SPRINGFIELD IL
62711-9252
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-2273
  • Fax: 818-357-2505
Mailing address:
  • Phone: 217-547-9100
  • Fax: 217-547-9236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0008728
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056011881
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27705
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: