=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568796910
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHERIE EURTON PH.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2009
-----------------------------------------------------
Last Update Date | 01/12/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11959 MARIPOSA RD
-----------------------------------------------------
City | HESPERIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92345-1696
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-671-4345
-----------------------------------------------------
Fax | 936-671-4321
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11959 MARIPOSA RD
-----------------------------------------------------
City | HESPERIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92345-1696
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-671-4345
-----------------------------------------------------
Fax | 936-671-4321
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------