Provider Demographics
NPI:1518003250
Name:PFENT, CHERYL ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANN
Last Name:PFENT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31573 RANCHO PUEBLO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4854
Mailing Address - Country:US
Mailing Address - Phone:858-279-1223
Mailing Address - Fax:858-467-7161
Practice Address - Street 1:31573 RANCHO PUEBLO RD STE 200
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4854
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:858-467-7161
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4330103TC0700X
CA18285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical