Provider Demographics
NPI:1700278603
Name:OSHITA, SHARON (MS, ATC, MMCIT, CMT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:OSHITA
Suffix:
Gender:F
Credentials:MS, ATC, MMCIT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 ESTABROOK ST
Mailing Address - Street 2:UNIT C
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3441
Mailing Address - Country:US
Mailing Address - Phone:510-385-3488
Mailing Address - Fax:
Practice Address - Street 1:444 ESTUDILLO AVE STE C
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4923
Practice Address - Country:US
Practice Address - Phone:510-385-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1196025212255A2300X
CA37552225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist