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General NPI Number Information
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NPI Number | 1548764202
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Entity Type | Organization
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Legal Business Name | EMILY CHEATUM, PSYD., PSYCHOLOGY CORPORATION
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 2400 E KATELLA AVE STE 800
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City | ANAHEIM
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State | CA
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Zip | 92806-5955
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Country | US
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Telephone | 714-865-9422
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Fax |
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Provider Business Mailing Address
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Address Line | 109 PRIMROSE DR
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-2511
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Country | US
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Telephone | 714-865-9422
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. EMILY CHEATUM
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Credential | PSY.D
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Telephone | 714-865-9422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PSY22328
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License Number State | CA
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