Provider Demographics
NPI:1417350307
Name:CHERIN, SAMANTHA BETH (NP, CNS)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:BETH
Last Name:CHERIN
Suffix:
Gender:F
Credentials:NP, CNS
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:BETH
Other - Last Name:THEAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4336 DON LUIS DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4233
Mailing Address - Country:US
Mailing Address - Phone:310-795-4294
Mailing Address - Fax:
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-795-4294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNS4168364SA2100X
CANP95001059363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care