Provider Demographics
NPI:1013625722
Name:MALI, SHARMILA
Entity Type:Individual
Prefix:
First Name:SHARMILA
Middle Name:
Last Name:MALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N SIGNAL ST STE M
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2600
Mailing Address - Country:US
Mailing Address - Phone:805-669-7299
Mailing Address - Fax:
Practice Address - Street 1:206 N SIGNAL ST STE M
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2600
Practice Address - Country:US
Practice Address - Phone:805-669-7299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30799225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist