Healthcare Provider Details
I. General information
NPI: 1952217549
Provider Name (Legal Business Name): CHERYL PETERSON MARRIAGE AND FAMILY THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
531 S WASHINGTON ST
SONORA CA
95370-5114
US
IV. Provider business mailing address
PO BOX 4452
SONORA CA
95370-1452
US
V. Phone/Fax
- Phone: 209-559-2432
- Fax: 209-532-5003
- Phone: 209-559-2432
- Fax: 209-532-5003
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHERYL
LYNN
PETERSON
Title or Position: MFT/OWNER
Credential: MS
Phone: 209-559-2432