Provider Demographics
NPI:1659568988
Name:OBORN, SHARYL H (PT)
Entity Type:Individual
Prefix:MS
First Name:SHARYL
Middle Name:H
Last Name:OBORN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43404 CALLE ESPADA
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-8836
Mailing Address - Country:US
Mailing Address - Phone:760-668-8248
Mailing Address - Fax:
Practice Address - Street 1:43404 CALLE ESPADA
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8836
Practice Address - Country:US
Practice Address - Phone:760-668-8248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT5335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist