Provider Demographics
NPI:1457771107
Name:MWERO, CHERISSE ANTOINETTE BENT (MD)
Entity type:Individual
Prefix:
First Name:CHERISSE
Middle Name:ANTOINETTE BENT
Last Name:MWERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHERISSE
Other - Middle Name:ANTOINETTE
Other - Last Name:BENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4860 Y ST
Mailing Address - Street 2:SUITE 3600
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-3514
Mailing Address - Fax:916-734-6525
Practice Address - Street 1:10956 DONNER PASS RD STE 240
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4863
Practice Address - Country:US
Practice Address - Phone:530-582-6368
Practice Address - Fax:530-550-6749
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1401582084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty