MEDICARE: SHERRY LYNN GREENBERG LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC38171	CA

General Provider Information

NPI Number	:	1346479631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY LYNN GREENBERG LMFT

Provider Business Mailing Address
First Line	:	36 MALAGA COVE PLZ
Second Line	:	SUITE 207
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-6811
Country	:	US
Telephone Number	:	310-791-2013
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 MALAGA COVE PLZ
Second Line	:	SUITE 207
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-6811
Country	:	US
Telephone Number	:	310-791-2013
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2009
Last Update Date	:	07/07/2009

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