Provider Demographics
NPI:1922624378
Name:WILSON, SHERRI CHERISE
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:CHERISE
Last Name:WILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:CHERISE
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10850 GOLD CENTER DR STE 325
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6177
Mailing Address - Country:US
Mailing Address - Phone:916-364-8395
Mailing Address - Fax:
Practice Address - Street 1:10850 GOLD CENTER DR STE 325
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6177
Practice Address - Country:US
Practice Address - Phone:916-364-8395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator