Provider Demographics
NPI:1356057244
Name:CHEUNG, ANOUSONE CATHERINE
Entity type:Individual
Prefix:
First Name:ANOUSONE
Middle Name:CATHERINE
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANOUSONE
Other - Middle Name:CATHERINE
Other - Last Name:INTHAVONGXAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29291 MOON HILL CT
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7315
Mailing Address - Country:US
Mailing Address - Phone:951-692-5206
Mailing Address - Fax:
Practice Address - Street 1:24100 MONROE AVE
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9507
Practice Address - Country:US
Practice Address - Phone:951-600-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4506225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist