Provider Demographics
NPI:1912057308
Name:CHERRIE, BECKY (MFT)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:CHERRIE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22231 MULHOLLAND HWY
Mailing Address - Street 2:208
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5123
Mailing Address - Country:US
Mailing Address - Phone:818-222-9300
Mailing Address - Fax:818-223-8224
Practice Address - Street 1:22231 MULHOLLAND HWY
Practice Address - Street 2:208
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5123
Practice Address - Country:US
Practice Address - Phone:818-222-9300
Practice Address - Fax:818-223-8224
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist