Healthcare Provider Details

I. General information

NPI: 1760104277
Provider Name (Legal Business Name): CHLOE LOUISE STINETORF SHERRILL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHLOE LOUISE STINETORF

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 CEDAR LODGE TER
LOS ANGELES CA
90039-3501
US

IV. Provider business mailing address

1929 CEDAR LODGE TER
LOS ANGELES CA
90039-3501
US

V. Phone/Fax

Practice location:
  • Phone: 510-872-6390
  • Fax:
Mailing address:
  • Phone: 510-872-6390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY36596
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: