Provider Demographics
NPI:1861745994
Name:MCCOY, SHERRY MARIE (PMHCNS, APRNBC)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:MARIE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:PMHCNS, APRNBC
Other - Prefix:MISS
Other - First Name:SHERRY
Other - Middle Name:MARIE
Other - Last Name:HAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2960 CAMINO DIABLO STE 105
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3945
Mailing Address - Country:US
Mailing Address - Phone:800-892-2695
Mailing Address - Fax:
Practice Address - Street 1:801 2ND AVE
Practice Address - Street 2:REGUS AT THE NORTON BLDG
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1576
Practice Address - Country:US
Practice Address - Phone:800-892-2695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN096899364SP0808X
WAAP61211676364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health