Provider Demographics
NPI:1295385474
Name:TRUSO, CHEREE MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:CHEREE
Middle Name:MICHELLE
Last Name:TRUSO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHEREE
Other - Middle Name:MICHELLE
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 LINCOLN AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-4908
Mailing Address - Country:US
Mailing Address - Phone:707-255-3719
Mailing Address - Fax:
Practice Address - Street 1:1046 BELLA DR
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-1602
Practice Address - Country:US
Practice Address - Phone:707-257-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor