Provider Demographics
NPI:1245914019
Name:GIBBONS, SHERRY ANNETTE (MSW)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:ANNETTE
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:SHERRY
Other - Middle Name:ANNETTE
Other - Last Name:DANYEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-0043
Mailing Address - Country:US
Mailing Address - Phone:707-951-7451
Mailing Address - Fax:
Practice Address - Street 1:5905 LAKE EARL DR
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95532-0002
Practice Address - Country:US
Practice Address - Phone:707-465-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program