Provider Demographics
NPI:1659959179
Name:PORAT, SHERON (MSW)
Entity type:Individual
Prefix:
First Name:SHERON
Middle Name:
Last Name:PORAT
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17777 VENTURA BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3738
Mailing Address - Country:US
Mailing Address - Phone:323-818-3335
Mailing Address - Fax:
Practice Address - Street 1:17777 VENTURA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3738
Practice Address - Country:US
Practice Address - Phone:213-908-1234
Practice Address - Fax:213-908-1233
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1005621041C0700X
CA1293811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical