Healthcare Provider Details

I. General information

NPI: 1962490383
Provider Name (Legal Business Name): SHERI L. WHITT M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 WEEOT WAY
ARCATA CA
95521-4734
US

IV. Provider business mailing address

7923 BERTA RD
EUREKA CA
95503-9641
US

V. Phone/Fax

Practice location:
  • Phone: 707-825-5060
  • Fax: 707-825-6753
Mailing address:
  • Phone: 707-825-5060
  • Fax: 707-825-6753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC32300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: