Provider Demographics
NPI:1609390798
Name:SHERRILL, ROXANNE (MA)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:SHERRILL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7671 32ND ST
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-1901
Mailing Address - Country:US
Mailing Address - Phone:916-899-0656
Mailing Address - Fax:
Practice Address - Street 1:11815 EDUCATION ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2410
Practice Address - Country:US
Practice Address - Phone:530-888-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist