Provider Demographics
NPI:1427125707
Name:WILKINS, SHERRY (MFT)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 W VERMONT AVE
Mailing Address - Street 2:SUITE #104
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6584
Mailing Address - Country:US
Mailing Address - Phone:760-432-9884
Mailing Address - Fax:760-432-9553
Practice Address - Street 1:474 W VERMONT AVE
Practice Address - Street 2:SUITE #104
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6584
Practice Address - Country:US
Practice Address - Phone:760-432-9884
Practice Address - Fax:760-432-9553
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist