Provider Demographics
NPI:1356546766
Name:LEE, SHERRIE D (MS, EDD)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:D
Last Name:LEE
Suffix:
Gender:F
Credentials:MS, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 W 230TH ST APT 117
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3801
Mailing Address - Country:US
Mailing Address - Phone:310-953-8254
Mailing Address - Fax:
Practice Address - Street 1:3711 W 230TH ST APT 117
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-592-1624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT86706106H00000X
CAPSY33937103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist