Provider Demographics
NPI:1093463747
Name:RALEY, SHERRY ANDERSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:ANDERSON
Last Name:RALEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 CASELLI AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2325
Mailing Address - Country:US
Mailing Address - Phone:415-252-7828
Mailing Address - Fax:
Practice Address - Street 1:324 CASELLI AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2325
Practice Address - Country:US
Practice Address - Phone:415-252-7828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27342103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE