1730818725 NPI number — MRS. SHERI LURLENE BRAUDRICK-DOGINS SCHOOL PSYCHOLOGIST

Table of content: MRS. SHERI LURLENE BRAUDRICK-DOGINS SCHOOL PSYCHOLOGIST (NPI 1730818725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730818725 NPI number — MRS. SHERI LURLENE BRAUDRICK-DOGINS SCHOOL PSYCHOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRAUDRICK-DOGINS
Provider First Name:
SHERI
Provider Middle Name:
LURLENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SCHOOL PSYCHOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRAUDRICK
Provider Other First Name:
SHERI
Provider Other Middle Name:
LURLENE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CREDENTIAL
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730818725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 WINCHESTER CIR APT B309
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS GATOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95032-1859
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-331-3217
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 WINCHESTER CIR APT B309
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS GATOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95032-1859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-331-3217
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TB0200X , with the licence number:  0824 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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