Provider Demographics
NPI:1962895581
Name:ENGEL, SHARLEEN
Entity type:Individual
Prefix:
First Name:SHARLEEN
Middle Name:
Last Name:ENGEL
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 1:1803 TERMINO AVE
Mailing Address - Street 2:# 2402
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2691
Mailing Address - Country:US
Mailing Address - Phone:973-738-2585
Mailing Address - Fax:562-494-8396
Practice Address - Street 1:1803 TERMINO AVE
Practice Address - Street 2:# 2402
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2691
Practice Address - Country:US
Practice Address - Phone:973-738-2585
Practice Address - Fax:562-494-8396
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7757171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7757OtherOCCUPATIONAL THERAPIST