Provider Demographics
NPI:1942234265
Name:FERRIS, SHARON LOUISE (MFCC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LOUISE
Last Name:FERRIS
Suffix:
Gender:F
Credentials:MFCC
Other - Prefix:MS
Other - First Name:SHERRI
Other - Middle Name:LOUISE
Other - Last Name:FERRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFCC
Mailing Address - Street 1:1819 POLK ST
Mailing Address - Street 2:SUITE 164
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3003
Mailing Address - Country:US
Mailing Address - Phone:415-673-5311
Mailing Address - Fax:415-673-5380
Practice Address - Street 1:1150 LOMBARD ST
Practice Address - Street 2:#39
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-9102
Practice Address - Country:US
Practice Address - Phone:415-673-5311
Practice Address - Fax:415-673-5380
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMP17797106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMP17797OtherMFC LICENSE