Provider Demographics
NPI:1225063126
Name:STEJSKAL, CHERYL ANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANNE
Last Name:STEJSKAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-0130
Mailing Address - Country:US
Mailing Address - Phone:209-704-2643
Mailing Address - Fax:209-829-0499
Practice Address - Street 1:340 I ST
Practice Address - Street 2:SUITE D
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-4143
Practice Address - Country:US
Practice Address - Phone:209-704-2643
Practice Address - Fax:209-829-0499
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical