Provider Demographics
NPI:1073265930
Name:SHERWOOD, LARRY D (LMFT)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:D
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 NEWCASTLE GAP DR
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7512
Mailing Address - Country:US
Mailing Address - Phone:916-248-1688
Mailing Address - Fax:
Practice Address - Street 1:2261 NEWCASTLE GAP DR
Practice Address - Street 2:
Practice Address - City:GOLD RIVER
Practice Address - State:CA
Practice Address - Zip Code:95670-7512
Practice Address - Country:US
Practice Address - Phone:916-248-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130709106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist