Provider Demographics
NPI:1205528981
Name:SHEREEN MOHSEN PSYCHOLOGY CORP.
Entity type:Organization
Organization Name:SHEREEN MOHSEN PSYCHOLOGY CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:408-680-4114
Mailing Address - Street 1:1101 S WINCHESTER BLVD STE J218
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3919
Mailing Address - Country:US
Mailing Address - Phone:408-680-4114
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD STE J205
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3918
Practice Address - Country:US
Practice Address - Phone:408-680-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty