Provider Demographics
NPI:1962570929
Name:CHENEY, TOM (LMFT)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:
Last Name:CHENEY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1373 SPENCER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-1757
Mailing Address - Country:US
Mailing Address - Phone:408-874-5624
Mailing Address - Fax:408-297-5064
Practice Address - Street 1:701 S ABEL ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5243
Practice Address - Country:US
Practice Address - Phone:408-934-5123
Practice Address - Fax:408-957-5807
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6334OtherSANTA CLARA COUNTY ID