Healthcare Provider Details

I. General information

NPI: 1861125817
Provider Name (Legal Business Name): SHERMAN CHERRY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 KNOLLCREST DR STE 120
REDDING CA
96002-0121
US

IV. Provider business mailing address

3800 COOLIDGE AVE
OAKLAND CA
94602-3399
US

V. Phone/Fax

Practice location:
  • Phone: 530-392-4399
  • Fax:
Mailing address:
  • Phone: 510-482-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: