Provider Demographics
NPI:1558577692
Name:NEGRIN, CHERYL (NP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:NEGRIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1469 HUMBOLDT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:335 S MCDOWELL BLVD
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-3507
Practice Address - Country:US
Practice Address - Phone:707-293-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA08618363LW0102X
CANP8618363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMM70116GMedicaid
CACMM70370FMedicaid
CACMM70268FMedicaid
CAZZR11629FMedicaid