Provider Demographics
NPI:1134641483
Name:FELZER, CHERIE LYNN (MFT)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:LYNN
Last Name:FELZER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 MONTECITO AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4552
Mailing Address - Country:US
Mailing Address - Phone:610-420-1035
Mailing Address - Fax:
Practice Address - Street 1:111 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5918
Practice Address - Country:US
Practice Address - Phone:510-788-0876
Practice Address - Fax:510-788-0876
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93350101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health