Provider Demographics
NPI:1972833184
Name:SHERROD, RHODA LORETTA (CADC II)
Entity Type:Individual
Prefix:MS
First Name:RHODA
Middle Name:LORETTA
Last Name:SHERROD
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-1425
Mailing Address - Country:US
Mailing Address - Phone:626-398-3796
Mailing Address - Fax:626-398-3895
Practice Address - Street 1:1118 WOOD ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-1425
Practice Address - Country:US
Practice Address - Phone:323-627-0326
Practice Address - Fax:323-627-0326
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARA858409101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)