Healthcare Provider Details

I. General information

NPI: 1477423721
Provider Name (Legal Business Name): SHARMAINE ALCANTARA ESCALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25402 PACIFICA AVE
MISSION VIEJO CA
92691-3854
US

IV. Provider business mailing address

10326 DEWEY DR
GARDEN GROVE CA
92840-1114
US

V. Phone/Fax

Practice location:
  • Phone: 657-276-7030
  • Fax:
Mailing address:
  • Phone: 657-276-7030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: