Provider Demographics
NPI:1568260446
Name:OERTEL, CHERIE ELAINE (PHD)
Entity type:Individual
Prefix:DR
First Name:CHERIE
Middle Name:ELAINE
Last Name:OERTEL
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ALMARIDA DR APT E5
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0220
Mailing Address - Country:US
Mailing Address - Phone:669-251-5315
Mailing Address - Fax:
Practice Address - Street 1:1101 S WINCHESTER BLVD STE A101
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3914
Practice Address - Country:US
Practice Address - Phone:408-412-0931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94028858103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist