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General NPI Number Information
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NPI Number | 1194050708
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Entity Type | Organization
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Legal Business Name | SHARP HEALTHCARE
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 8990 MIRAMAR ROAD 275
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City | SAN DIEGO
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State | CA
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Zip | 92126
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Country | US
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Telephone | 858-653-6017
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Fax |
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Provider Business Mailing Address
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Address Line | 3860 ELIJAH CT
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City | SAN DIEGO
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State | CA
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Zip | 92130
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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 | PEDIATRIC OCCUPATIONAL THERAPIST
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Name | SARAH MCNEILL
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Credential |
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Telephone | 619-200-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OT 4056
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License Number State | CA
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