Provider Demographics
NPI:1922187137
Name:SHERWOOD, ROBERTA L (MA MFT)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:L
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:MS
Other - First Name:ROBERTA
Other - Middle Name:S
Other - Last Name:TAHER-ZADEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 VALLEY DRIVE
Mailing Address - Street 2:39
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266
Mailing Address - Country:US
Mailing Address - Phone:310-546-3037
Mailing Address - Fax:310-546-8794
Practice Address - Street 1:3760 MOTOR AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034
Practice Address - Country:US
Practice Address - Phone:310-558-9855
Practice Address - Fax:310-546-8794
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35651106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist