Provider Demographics
NPI:1750495701
Name:LEACH, SHERI LYNN (CAS)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:LEACH
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 E SOUTHGATE DR
Mailing Address - Street 2:STE D
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823
Mailing Address - Country:US
Mailing Address - Phone:916-394-1000
Mailing Address - Fax:916-394-1010
Practice Address - Street 1:7225 E SOUTHGATE DR
Practice Address - Street 2:STE D
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823
Practice Address - Country:US
Practice Address - Phone:916-394-1000
Practice Address - Fax:916-394-1010
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
01051324101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)