Provider Demographics
NPI:1992712715
Name:KHAN, SHERAH (MS, MFT)
Entity type:Individual
Prefix:MS
First Name:SHERAH
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3867
Mailing Address - Country:US
Mailing Address - Phone:916-284-5369
Mailing Address - Fax:
Practice Address - Street 1:3815 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-3867
Practice Address - Country:US
Practice Address - Phone:916-388-6400
Practice Address - Fax:916-649-7158
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48454106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist