Healthcare Provider Details

I. General information

NPI: 1427788041
Provider Name (Legal Business Name): CHEKESHIA S TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 E WASHINGTON BLVD STE 230
PASADENA CA
91107-1449
US

IV. Provider business mailing address

9200 MILLIKEN AVE APT 7205
RANCHO CUCAMONGA CA
91730-8512
US

V. Phone/Fax

Practice location:
  • Phone: 626-296-8900
  • Fax:
Mailing address:
  • Phone: 909-257-9948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number107237
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: