Provider Demographics
NPI:1225510696
Name:CALHOUN, SHERI SHANESE
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:SHANESE
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E. LIVE OAK AVENUE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006
Mailing Address - Country:US
Mailing Address - Phone:626-254-1400
Mailing Address - Fax:626-447-4792
Practice Address - Street 1:330 E. LIVE OAK AVENUE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006
Practice Address - Country:US
Practice Address - Phone:626-254-1400
Practice Address - Fax:626-447-4792
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 390200000X
CAASW923331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program