Provider Demographics
NPI:1811082852
Name:ANDERSON, CHERYL D (MFT)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:D
Last Name:ANDERSON
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 1:2180 JEFFERSON ST # 214
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-1250
Mailing Address - Country:US
Mailing Address - Phone:707-225-4405
Mailing Address - Fax:
Practice Address - Street 1:2180 JEFFERSON ST # 214
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1250
Practice Address - Country:US
Practice Address - Phone:707-225-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40637106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist