Provider Demographics
NPI:1659591840
Name:MILLS, CHERIE LYNN (MFT)
Entity Type:Individual
Prefix:MS
First Name:CHERIE
Middle Name:LYNN
Last Name:MILLS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-4320
Mailing Address - Country:US
Mailing Address - Phone:714-343-7644
Mailing Address - Fax:714-486-1629
Practice Address - Street 1:228 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-4320
Practice Address - Country:US
Practice Address - Phone:714-343-7633
Practice Address - Fax:714-486-1629
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 40443106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist