Sharen Dee Hale, LPT

Individual provider Active NPI Other Technician · Nipomo, CA

NPI 1780064865 · NPPES record last updated Jun 4, 2015

Key facts

NPI
1780064865
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
License
PT 36410 (CA)
Practice address
518 Higos Way
Nipomo, CA 93444-9126
Phone
(805) 709-3366
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X PT 36410 CA Yes

Addresses

Primary practice location

518 Higos Way
Nipomo, CA 93444-9126

Mailing address

518 Higos Way
Nipomo, CA 93444-9126
Phone (805) 709-3366

Other providers in Nipomo, CA

All providers in Nipomo, CA · Other Technician in California

Sources for this page

Verify at the official NPI Registry.