Healthcare Provider Details

I. General information

NPI: 1497901771
Provider Name (Legal Business Name): CHRISTINA S SHERMAN PH.D., MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

577 E ELDER ST SUITE C
FALLBROOK CA
92028-3079
US

IV. Provider business mailing address

PO BOX 2140
FALLBROOK CA
92088-2140
US

V. Phone/Fax

Practice location:
  • Phone: 760-419-7683
  • Fax: 760-728-7872
Mailing address:
  • Phone: 760-419-7683
  • Fax: 760-728-7872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC37775
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: