MEDICARE: SHERRY L COOK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LCS 4414	CA

General Provider Information

NPI Number	:	1184645582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY L COOK

Provider Business Mailing Address
First Line	:	8742 CAMINITO ABRAZO
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1601
Country	:	US
Telephone Number	:	858-945-2032
Fax Number	:

Provider Business Practice Location Address
First Line	:	6475 ALVARADO RD
Second Line	:	STE. 233
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5003
Country	:	US
Telephone Number	:	858-279-1223
Fax Number	:	619-229-2333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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Directions to “ SHERRY L COOK ” Practice Location

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