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General NPI Number Information
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NPI Number | 1669502407
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Entity Type | Individual
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Provider Name | TRACI L. SHERMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 6957 N FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90042-1245
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Country | US
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Telephone | 323-855-0483
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Fax |
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Provider Business Mailing Address
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Address Line | 1478 PEPPER DR.
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City | PASADENA
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State | CA
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Zip | 91104
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Country | US
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Telephone | 626-797-1181
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS25953
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License Number State | CA
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