Provider Demographics
NPI:1144220146
Name:SHERMAN, SCOTT P (PHD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:P
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N LURING DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6840
Mailing Address - Country:US
Mailing Address - Phone:760-836-1833
Mailing Address - Fax:760-778-0365
Practice Address - Street 1:160 N LURING DR
Practice Address - Street 2:SUITE H
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6840
Practice Address - Country:US
Practice Address - Phone:760-836-1833
Practice Address - Fax:760-778-0365
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5825103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL58250Medicare ID - Type Unspecified