Healthcare Provider Details

I. General information

NPI: 1184534976
Provider Name (Legal Business Name): CHERYL DAVILA MA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

994 G ST
CRESCENT CITY CA
95531-3417
US

IV. Provider business mailing address

15898 US HIGHWAY 101 N
KLAMATH CA
95548-9381
US

V. Phone/Fax

Practice location:
  • Phone: 707-464-0320
  • Fax:
Mailing address:
  • Phone: 559-396-7508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: