Provider Demographics
NPI:1871890574
Name:BECKER, SHERYL LYNN (MFT)
Entity type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:LYNN
Last Name:BECKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5241 E SANTA ANA CANYON RD
Mailing Address - Street 2:STE. 130
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3737
Mailing Address - Country:US
Mailing Address - Phone:714-637-0800
Mailing Address - Fax:714-637-1169
Practice Address - Street 1:5241 E SANTA ANA CANYON RD
Practice Address - Street 2:STE. 130
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3737
Practice Address - Country:US
Practice Address - Phone:714-637-0800
Practice Address - Fax:714-637-1169
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist