Provider Demographics
NPI:1013532019
Name:COLINA, SHERI-AM
Entity Type:Individual
Prefix:
First Name:SHERI-AM
Middle Name:
Last Name:COLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 N RIMSDALE AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3554
Mailing Address - Country:US
Mailing Address - Phone:626-627-1247
Mailing Address - Fax:
Practice Address - Street 1:688 N RIMSDALE AVE APT 105
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3554
Practice Address - Country:US
Practice Address - Phone:626-627-1247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist