Healthcare Provider Details

I. General information

NPI: 1962310631
Provider Name (Legal Business Name): MS. SHERYL ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5834 ADENMOOR AVE
LAKEWOOD CA
90713-1002
US

IV. Provider business mailing address

3215 PINE AVE
LONG BEACH CA
90807-5050
US

V. Phone/Fax

Practice location:
  • Phone: 562-512-0403
  • Fax:
Mailing address:
  • Phone: 562-254-5277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number25-434515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: