Provider Demographics
NPI:1689398935
Name:PERCY, CHIKYRA ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHIKYRA
Middle Name:ANNE
Last Name:PERCY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13312 RANCHERO RD STE18
Mailing Address - Street 2:PMB164
Mailing Address - City:OAK HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92344
Mailing Address - Country:US
Mailing Address - Phone:760-953-6746
Mailing Address - Fax:
Practice Address - Street 1:12555 MARIPOSA RD STE J
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-6010
Practice Address - Country:US
Practice Address - Phone:760-953-6746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1091501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical