Healthcare Provider Details

I. General information

NPI: 1891352589
Provider Name (Legal Business Name): SHERLYN ALISA FRANK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 WILSHIRE BLVD STE 290-26
LOS ANGELES CA
90010-3540
US

IV. Provider business mailing address

FLAT 34 HANNAY HOUSE 23 SCOTT AVENUE
LONDON UNITED KINGDOM
SW15 3PD
GB

V. Phone/Fax

Practice location:
  • Phone: 213-441-6780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number79605
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number071491
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: