Provider Demographics
NPI:1083744296
Name:HERRERA, SHARLEEN RENEE (OTR)
Entity Type:Individual
Prefix:
First Name:SHARLEEN
Middle Name:RENEE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HERITAGE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-8038
Mailing Address - Country:US
Mailing Address - Phone:949-215-5246
Mailing Address - Fax:
Practice Address - Street 1:26 HERITAGE
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-8038
Practice Address - Country:US
Practice Address - Phone:949-215-5246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8869225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation