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NPI Code Detail

MEDICARE: MRS. SHELBY CHRISTINE HERGESELL M.S., OTR/L

MEDICARE: MRS. SHELBY CHRISTINE HERGESELL M.S., OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist10494CA

General Provider Information

NPI Number : 1700714375
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHELBY CHRISTINE HERGESELL M.S., OTR/L
Provider Business Mailing Address
First Line : 200 KALMUS DR
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-5922
Country : US
Telephone Number : 714-966-4000
Fax Number :
Provider Business Practice Location Address
First Line : 200 KALMUS DR
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-5922
Country : US
Telephone Number : 714-966-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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