Provider Demographics
NPI:1013470673
Name:SHERMAN, STEPHANIE CHERI (ASW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CHERI
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:CHERI
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASW
Mailing Address - Street 1:1000 BROADWAY STE 100
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-4899
Mailing Address - Country:US
Mailing Address - Phone:619-550-8853
Mailing Address - Fax:
Practice Address - Street 1:1000 BROADWAY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-7417
Practice Address - Country:US
Practice Address - Phone:619-401-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAASW880541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty