Healthcare Provider Details

I. General information

NPI: 1356275291
Provider Name (Legal Business Name): CHERIE DOCKERY LICENSED CLINICAL SOCIAL WORK CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 COFFEE RD STE 11
MODESTO CA
95355-4244
US

IV. Provider business mailing address

1705 7 FLS
MODESTO CA
95355-6007
US

V. Phone/Fax

Practice location:
  • Phone: 209-604-7734
  • Fax:
Mailing address:
  • Phone: 209-604-7734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. CHERIE DOCKERY
Title or Position: THERAPIST
Credential: LCSW
Phone: 209-324-0844