Provider Demographics
NPI:1184974289
Name:SHERWOOD, MEG ANNE (COTA)
Entity type:Individual
Prefix:MS
First Name:MEG
Middle Name:ANNE
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3899 HAINES ST APT 104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-6355
Mailing Address - Country:US
Mailing Address - Phone:760-484-2298
Mailing Address - Fax:
Practice Address - Street 1:3899 HAINES ST APT 104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-6355
Practice Address - Country:US
Practice Address - Phone:760-484-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-16
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1834224Z00000X
SC12829225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant