Provider Demographics
NPI:1306398805
Name:HIXSON, CHERYL ANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:HIXSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6276 N 1ST ST STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5400
Mailing Address - Country:US
Mailing Address - Phone:559-492-6778
Mailing Address - Fax:559-448-0164
Practice Address - Street 1:6276 N 1ST ST STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5400
Practice Address - Country:US
Practice Address - Phone:559-492-6778
Practice Address - Fax:559-412-7564
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-31
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist