Provider Demographics
NPI:1912267055
Name:WORCESTER, CHERI (EDD, BCBA-D, LBA)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:WORCESTER
Suffix:
Gender:F
Credentials:EDD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3466 MARINER RD
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-5041
Mailing Address - Country:US
Mailing Address - Phone:925-813-0611
Mailing Address - Fax:
Practice Address - Street 1:3466 MARINER RD
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-5041
Practice Address - Country:US
Practice Address - Phone:925-813-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-09-5889103K00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor