Provider Demographics
NPI:1053088765
Name:SHERMAN, ALEXANDRA NOELLE COULLES (LMFT, LPCC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NOELLE COULLES
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT, LPCC
Mailing Address - Street 1:16767 BERNARDO CENTER DR UNIT 270594
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92198-7064
Mailing Address - Country:US
Mailing Address - Phone:619-806-0203
Mailing Address - Fax:
Practice Address - Street 1:200 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084
Practice Address - Country:US
Practice Address - Phone:619-806-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124625106H00000X
CA9921101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional