Provider Demographics
NPI:1134923188
Name:FUENTES, SHARLEEN
Entity type:Individual
Prefix:
First Name:SHARLEEN
Middle Name:
Last Name:FUENTES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E YUCCA ST APT 46
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-6488
Mailing Address - Country:US
Mailing Address - Phone:805-607-1019
Mailing Address - Fax:
Practice Address - Street 1:200 E YUCCA ST APT 46
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-6488
Practice Address - Country:US
Practice Address - Phone:805-607-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician