Provider Demographics
NPI:1568518132
Name:WISEMAN, SHERYL ANN
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:WISEMAN
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 1:148 LILAC CIR
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-1014
Mailing Address - Country:US
Mailing Address - Phone:510-245-9565
Mailing Address - Fax:
Practice Address - Street 1:1420 WILLOW PASS RD
Practice Address - Street 2:200
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5223
Practice Address - Country:US
Practice Address - Phone:925-646-5480
Practice Address - Fax:925-646-5622
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health