Provider Demographics
NPI:1750642047
Name:SHERMAN, EDWARD ROBERT (MA)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:ROBERT
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33175 TEMECULA PKWY
Mailing Address - Street 2:STE. A340
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-7310
Mailing Address - Country:US
Mailing Address - Phone:951-543-9424
Mailing Address - Fax:
Practice Address - Street 1:33175 TEMECULA PKWY
Practice Address - Street 2:STE. A340
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-7310
Practice Address - Country:US
Practice Address - Phone:951-543-9424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-03
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health