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NPI Code Detail

MEDICARE: MR. STEVEN ERIC SHERRY LCSW

MEDICARE: MR. STEVEN ERIC SHERRY LCSW
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
1171M00000XCase Manager/Care CoordinatorLCSW 20944CA

General Provider Information

NPI Number : 1669502936
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN ERIC SHERRY LCSW
Provider Business Mailing Address
First Line : 500 AIRPORT WAY
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-8500
Country : US
Telephone Number : 805-288-4420
Fax Number :
Provider Business Practice Location Address
First Line : 500 AIRPORT WAY
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-8500
Country : US
Telephone Number : 805-288-4420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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