Provider Demographics
NPI:1083084222
Name:DEOLIVEIRA, CHERISH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHERISH
Middle Name:
Last Name:DEOLIVEIRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W CHANDLER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6100
Mailing Address - Country:US
Mailing Address - Phone:480-524-0990
Mailing Address - Fax:702-977-7488
Practice Address - Street 1:1600 W CHANDLER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6100
Practice Address - Country:US
Practice Address - Phone:480-524-0990
Practice Address - Fax:702-977-7488
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10862103TC0700X
AZPSY-005118103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical