Provider Demographics
NPI:1821513326
Name:DENISON, CHEYENNE LINNEA
Entity Type:Individual
Prefix:MS
First Name:CHEYENNE
Middle Name:LINNEA
Last Name:DENISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 SHADOW CANYON CIR
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-1147
Mailing Address - Country:US
Mailing Address - Phone:951-207-2945
Mailing Address - Fax:
Practice Address - Street 1:341 CORPORATE TERRACE CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-6028
Practice Address - Country:US
Practice Address - Phone:714-881-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst