Provider Demographics
NPI:1770137879
Name:SHERRELL, GEOFFREY ERIK
Entity type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:ERIK
Last Name:SHERRELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5918 PILAR WAY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-7420
Mailing Address - Country:US
Mailing Address - Phone:317-679-7343
Mailing Address - Fax:
Practice Address - Street 1:13101 W WASHINGTON BLVD STE 215
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5173
Practice Address - Country:US
Practice Address - Phone:424-438-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT111750106H00000X
CA135651106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist