Provider Demographics
NPI:1578708616
Name:COBBS, SHERRITA M (BA)
Entity Type:Individual
Prefix:MS
First Name:SHERRITA
Middle Name:M
Last Name:COBBS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92556-0748
Mailing Address - Country:US
Mailing Address - Phone:951-807-0163
Mailing Address - Fax:
Practice Address - Street 1:41870 KALMIA ST STE 165
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8850
Practice Address - Country:US
Practice Address - Phone:951-696-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health