Provider Demographics
NPI:1902045263
Name:SHERBOURNE, TWYLA EYVONNE
Entity Type:Individual
Prefix:
First Name:TWYLA
Middle Name:EYVONNE
Last Name:SHERBOURNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4238 SCHWYHART LN
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-9779
Mailing Address - Country:US
Mailing Address - Phone:530-532-8796
Mailing Address - Fax:
Practice Address - Street 1:107 PARMAC RD
Practice Address - Street 2:STE 2
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2298
Practice Address - Country:US
Practice Address - Phone:530-891-2784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)