Provider Demographics
NPI:1780965301
Name:NEAL, CHERRI (NCAC, SAP/DOT, CASII)
Entity type:Individual
Prefix:
First Name:CHERRI
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:NCAC, SAP/DOT, CASII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1082
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93448-1082
Mailing Address - Country:US
Mailing Address - Phone:805-709-3359
Mailing Address - Fax:
Practice Address - Street 1:1003 MEADOW WAY
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-1807
Practice Address - Country:US
Practice Address - Phone:805-709-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist