Provider Demographics
NPI:1649987298
Name:BISCHOFF, SHERRE (BCMT)
Entity type:Individual
Prefix:
First Name:SHERRE
Middle Name:
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:BCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8211 SAN ANGELO DR APT C2
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7252
Mailing Address - Country:US
Mailing Address - Phone:562-302-5531
Mailing Address - Fax:
Practice Address - Street 1:8211 SAN ANGELO DR APT C2
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7252
Practice Address - Country:US
Practice Address - Phone:562-302-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3083225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist