Provider Demographics
NPI:1376322057
Name:MORGAN-GOSSETT, CHERIEKA JUANAE
Entity Type:Individual
Prefix:
First Name:CHERIEKA
Middle Name:JUANAE
Last Name:MORGAN-GOSSETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BUELLTON
Mailing Address - State:CA
Mailing Address - Zip Code:93427-9750
Mailing Address - Country:US
Mailing Address - Phone:805-705-8097
Mailing Address - Fax:
Practice Address - Street 1:592 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BUELLTON
Practice Address - State:CA
Practice Address - Zip Code:93427-9750
Practice Address - Country:US
Practice Address - Phone:805-705-8097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program