MEDICARE: SHERRY REASBECK

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	MFT22431	CA

General Provider Information

NPI Number	:	1699364372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY REASBECK

Provider Business Mailing Address
First Line	:	5440 MOREHOUSE DR STE 3800
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-6703
Country	:	US
Telephone Number	:	858-458-0388
Fax Number	:	858-458-0413

Provider Business Practice Location Address
First Line	:	5440 MOREHOUSE DR STE 3800
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-6703
Country	:	US
Telephone Number	:	858-458-0388
Fax Number	:	858-458-0413

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

Provider Enumeration Date	:	01/15/2021
Last Update Date	:	01/15/2021

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Directions to “ SHERRY REASBECK ” Practice Location

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