Healthcare Provider Details

I. General information

NPI: 1871539403
Provider Name (Legal Business Name): CATHERINE PIERCE CHEYETTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1676 SOLANO AVE
ALBANY CA
94707-2118
US

IV. Provider business mailing address

1520 SAN LORENZO AVE
BERKELEY CA
94707-1821
US

V. Phone/Fax

Practice location:
  • Phone: 510-526-5911
  • Fax: 510-526-5911
Mailing address:
  • Phone: 510-526-5911
  • Fax: 510-526-5911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCS16174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: