Provider Demographics
NPI:1073630364
Name:ANCHETA, MA CHERRYL (PT)
Entity type:Individual
Prefix:MS
First Name:MA
Middle Name:CHERRYL
Last Name:ANCHETA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:CHERRYL
Other - Middle Name:
Other - Last Name:ANCHETA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:45360 DESERT FOX DR
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4212
Mailing Address - Country:US
Mailing Address - Phone:760-610-2533
Mailing Address - Fax:760-619-2533
Practice Address - Street 1:45360 DESERT FOX DR
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-4212
Practice Address - Country:US
Practice Address - Phone:760-610-2533
Practice Address - Fax:760-610-2533
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT07010F225100000X
CT007847225100000X
PA018086225100000X
CA34492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist