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General NPI Number Information
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NPI Number | 1326526757
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Entity Type | Individual
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Provider Name | CHERYL ANN WHITTLE PH.D., LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/28/2018
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 4411 N CEDAR AVE STE 108
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City | FRESNO
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State | CA
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Zip | 93726-2538
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Country | US
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Telephone | 559-248-1548
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Fax |
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Provider Business Mailing Address
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Address Line | 1254 N LUCERNE LN
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City | FRESNO
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State | CA
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Zip | 93728-1713
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Country | US
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Telephone | 559-260-9162
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Fax | 559-499-1037
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 26764
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 26764
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License Number State | CA
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