Provider Demographics
NPI:1588045561
Name:DAVILA, CHEREE (RAS, CADC-CAS)
Entity Type:Individual
Prefix:
First Name:CHEREE
Middle Name:
Last Name:DAVILA
Suffix:
Gender:F
Credentials:RAS, CADC-CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 QUAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-8910
Mailing Address - Country:US
Mailing Address - Phone:831-245-7736
Mailing Address - Fax:
Practice Address - Street 1:1000 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-9644
Practice Address - Country:US
Practice Address - Phone:831-245-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD1313131120101YA0400X
CAC031420315101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)