Provider Demographics
NPI:1881777951
Name:SHEPPHIRD, SARI (PHD)
Entity type:Individual
Prefix:DR
First Name:SARI
Middle Name:
Last Name:SHEPPHIRD
Suffix:
Gender:F
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:PO BOX 66075
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-0075
Mailing Address - Country:US
Mailing Address - Phone:310-826-4300
Mailing Address - Fax:
Practice Address - Street 1:2550 OVERLAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3346
Practice Address - Country:US
Practice Address - Phone:310-826-4300
Practice Address - Fax:310-558-0799
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20922103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical