Provider Demographics
NPI:1760744635
Name:SHERMAN, JUSTINE OLIVIA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JUSTINE
Middle Name:OLIVIA
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:JUSTINE
Other - Middle Name:OLIVIA
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:147 E OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-3407
Mailing Address - Country:US
Mailing Address - Phone:626-355-1729
Mailing Address - Fax:626-836-6927
Practice Address - Street 1:147 E OLIVE AVE
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-3407
Practice Address - Country:US
Practice Address - Phone:626-355-1729
Practice Address - Fax:626-836-6927
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11356235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist