Healthcare Provider Details

I. General information

NPI: 1457830986
Provider Name (Legal Business Name): MRS. SHARON STEFANIE ACEITUNO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 LAUREL CANYON BLVD STE 500
NORTH HOLLYWOOD CA
91606-1562
US

IV. Provider business mailing address

6400 LAUREL CANYON BLVD STE 500
NORTH HOLLYWOOD CA
91606-1562
US

V. Phone/Fax

Practice location:
  • Phone: 818-901-4879
  • Fax:
Mailing address:
  • Phone: 818-901-4879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW142366
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: