Provider Demographics
NPI:1578799359
Name:KHAN, SHARMEEN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SHARMEEN
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 KEARNEY ST APT A
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3101
Mailing Address - Country:US
Mailing Address - Phone:510-868-4321
Mailing Address - Fax:
Practice Address - Street 1:125 RYAN INDUSTRIAL CT
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1772
Practice Address - Country:US
Practice Address - Phone:925-855-9810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-06
Last Update Date:2009-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7974225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics