Healthcare Provider Details

I. General information

NPI: 1023662012
Provider Name (Legal Business Name): SHARNELLE NAOMI KAMIBAYASHI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2019
Last Update Date: 04/12/2025
Certification Date: 04/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 S GAYLORD ST
DENVER CO
80209-4635
US

IV. Provider business mailing address

1033 S GAYLORD ST
DENVER CO
80209-4635
US

V. Phone/Fax

Practice location:
  • Phone: 303-282-5427
  • Fax:
Mailing address:
  • Phone: 808-383-9158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003171
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0003571
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: