Provider Demographics
NPI:1154027001
Name:VAN EYCK, CHEREE NICHOLE
Entity type:Individual
Prefix:
First Name:CHEREE
Middle Name:NICHOLE
Last Name:VAN EYCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHEREE
Other - Middle Name:NICHOLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3862 COUNTRY ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:96022-9573
Mailing Address - Country:US
Mailing Address - Phone:530-356-0165
Mailing Address - Fax:
Practice Address - Street 1:1441 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0811
Practice Address - Country:US
Practice Address - Phone:530-224-2700
Practice Address - Fax:530-224-2738
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA973681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical