Provider Demographics
NPI:1700019718
Name:SCHIAVO, CHERYL ANN (MFC #4507,CSAC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:SCHIAVO
Suffix:
Gender:F
Credentials:MFC #4507,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 ARNOLD DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-6537
Mailing Address - Country:US
Mailing Address - Phone:925-372-4213
Mailing Address - Fax:925-372-4216
Practice Address - Street 1:1320 ARNOLD DR
Practice Address - Street 2:SUITE 170
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6537
Practice Address - Country:US
Practice Address - Phone:925-372-4213
Practice Address - Fax:925-372-4216
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC.A.S.C.101YA0400X
CAM.F.C.45077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)