Healthcare Provider Details

I. General information

NPI: 1053249615
Provider Name (Legal Business Name): SHEYLA D ROSALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4688 ONTARIO MILLS PKWY
ONTARIO CA
91764-5104
US

IV. Provider business mailing address

1063 MCGAW AVE STE 100 100
IRVINE CA
92614-5554
US

V. Phone/Fax

Practice location:
  • Phone: 909-476-5747
  • Fax:
Mailing address:
  • Phone: 714-834-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: