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General NPI Number Information
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NPI Number | 1003632514
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Entity Type | Individual
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Provider Name | RAJESH SHARMA MSW, BCBA
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Gender | Male
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 17871 SANTIAGO BLVD STE 222
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City | VILLA PARK
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State | CA
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Zip | 92861-4126
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Country | US
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Telephone | 657-660-3156
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Fax | 657-600-0975
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Provider Business Mailing Address
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Address Line | 942 W SIERRA NEVADA WAY
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City | ORANGE
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State | CA
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Zip | 92865-2011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-16373
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License Number State |
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