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General NPI Number Information
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NPI Number | 1508237991
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Entity Type | Individual
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Provider Name | SHERREKA BRADY
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Gender | Female
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 230 LEAFWOOD CT
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City | SUINSUN
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State | CA
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Zip | 94585
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Country | US
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Telephone | 415-501-0194
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Fax |
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Provider Business Mailing Address
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Address Line | 1250 OLIVER RD # 1173
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City | FAIRFIELD
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State | CA
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Zip | 94534-3467
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Country | US
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Telephone | 415-501-0194
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 99646
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 120752
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License Number State | CA
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