Provider Demographics
NPI:1851551634
Name:HOUGLAND, CHERI E (PA)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:E
Last Name:HOUGLAND
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3082 MCMURRAY DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-3544
Mailing Address - Country:US
Mailing Address - Phone:530-365-4420
Mailing Address - Fax:530-365-5186
Practice Address - Street 1:9164 DESCHUTES RD
Practice Address - Street 2:
Practice Address - City:PALO CEDRO
Practice Address - State:CA
Practice Address - Zip Code:96073-8732
Practice Address - Country:US
Practice Address - Phone:530-547-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15953363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant