Provider Demographics
NPI:1093259426
Name:BEATRICE, CHERYL ANNE (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANNE
Last Name:BEATRICE
Suffix:
Gender:F
Credentials:PHD, LMFT
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5021 VERDUGO WAY
Mailing Address - Street 2:STE 105-218
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8675
Mailing Address - Country:US
Mailing Address - Phone:805-208-1256
Mailing Address - Fax:805-389-0234
Practice Address - Street 1:325 E HILLCREST DR STE 115
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-7782
Practice Address - Country:US
Practice Address - Phone:805-208-1256
Practice Address - Fax:805-601-5200
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-04
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAIMF81327106H00000X
CALMFT99156106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist