Provider Demographics
NPI:1780265199
Name:CHERMONT, ANNA CAROLINA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CAROLINA
Last Name:CHERMONT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:CAROLINA
Other - Last Name:CHERMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 PACIFICA APT 5308
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3356
Mailing Address - Country:US
Mailing Address - Phone:949-436-1608
Mailing Address - Fax:
Practice Address - Street 1:4650 W SUNSET BLVD # 53
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-3849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CA94026865103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist