Provider Demographics
NPI:1649494337
Name:TRENWITH, CHERYL ADEL (MFT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ADEL
Last Name:TRENWITH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 BRUNSWICK RD STE 9
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-9529
Mailing Address - Country:US
Mailing Address - Phone:530-680-1291
Mailing Address - Fax:
Practice Address - Street 1:565 BRUNSWICK RD STE 9
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-9529
Practice Address - Country:US
Practice Address - Phone:530-680-1291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41074106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist