Provider Demographics
NPI:1538308267
Name:SHERMAN, DAWNEL (LMT)
Entity Type:Individual
Prefix:
First Name:DAWNEL
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 FITZGERALD RD APT F
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4487
Mailing Address - Country:US
Mailing Address - Phone:805-857-1043
Mailing Address - Fax:805-306-9587
Practice Address - Street 1:1165 FITZGERALD RD APT F
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4487
Practice Address - Country:US
Practice Address - Phone:805-857-1043
Practice Address - Fax:805-306-9587
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15728-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist