Provider Demographics
NPI:1801144167
Name:MURRELL, CHERI LYNN (PTA)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:LYNN
Last Name:MURRELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9249 CARTHAY CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1124
Mailing Address - Country:US
Mailing Address - Phone:619-920-5027
Mailing Address - Fax:
Practice Address - Street 1:2355 NORTHSIDE DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2714
Practice Address - Country:US
Practice Address - Phone:619-260-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT0586225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant