Provider Demographics
NPI:1164441283
Name:SHERMAN, SCOTT LLOYD (MFC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:LLOYD
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0357
Mailing Address - Country:US
Mailing Address - Phone:707-445-1018
Mailing Address - Fax:707-445-1018
Practice Address - Street 1:350 E ST
Practice Address - Street 2:SUITE 300
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0357
Practice Address - Country:US
Practice Address - Phone:707-445-1018
Practice Address - Fax:707-445-1018
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 14936106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ55533Z12Medicare UPIN