Provider Demographics
NPI:1881971877
Name:MCSHERRY, JENNIFER A
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:MCSHERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12021 ROBSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1733
Mailing Address - Country:US
Mailing Address - Phone:804-309-9366
Mailing Address - Fax:
Practice Address - Street 1:12021 ROBSON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1733
Practice Address - Country:US
Practice Address - Phone:804-309-9366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002766225X00000X
CA10659225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA10659Medicaid
CA10659Medicaid