Provider Demographics
NPI:1043336431
Name:SHERMAN, RICHARD MERRILL (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MERRILL
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19634 VENTURA BLVD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2966
Mailing Address - Country:US
Mailing Address - Phone:818-708-9393
Mailing Address - Fax:818-705-6849
Practice Address - Street 1:19634 VENTURA BLVD
Practice Address - Street 2:SUITE 325
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2966
Practice Address - Country:US
Practice Address - Phone:818-708-9393
Practice Address - Fax:818-705-6849
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4927103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR25788Medicare UPIN
CACP4927Medicare ID - Type Unspecified