Provider Demographics
NPI:1699843474
Name:SHERMAN, LESLIE W (MFT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:W
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 EAST MILL STREET
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454
Mailing Address - Country:US
Mailing Address - Phone:805-350-4380
Mailing Address - Fax:805-267-4058
Practice Address - Street 1:526 EAST MILL STREET
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454
Practice Address - Country:US
Practice Address - Phone:805-350-4380
Practice Address - Fax:805-267-4058
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist