Provider Demographics
NPI:1093105041
Name:NALEVKA, CHERYL ANNE (MPT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:NALEVKA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20321 SW ACACIA ST STE 150
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1763
Mailing Address - Country:US
Mailing Address - Phone:949-851-8121
Mailing Address - Fax:949-851-9537
Practice Address - Street 1:20321 SW ACACIA ST STE 150
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-851-8121
Practice Address - Fax:949-851-9537
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA295437OtherPHYSICAL THERAPY BOARD OF CALIFORNIA