Provider Demographics
NPI:1346468303
Name:CHEATUM, EMILY MARIE (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MARIE
Last Name:CHEATUM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PRIMROSE DR
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2511
Mailing Address - Country:US
Mailing Address - Phone:714-865-9422
Mailing Address - Fax:
Practice Address - Street 1:1666 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-7417
Practice Address - Country:US
Practice Address - Phone:714-450-4174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health