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General NPI Number Information
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NPI Number | 1932474608
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Entity Type | Individual
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Provider Name | CHERI VANDERMEY M.A. BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 18008 SKY PARK CIR STE 110
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City | IRVINE
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State | CA
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Zip | 92614-6434
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Country | US
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Telephone | 949-474-1493
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Fax | 949-726-8324
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Provider Business Mailing Address
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Address Line | 233 BASELINE RD
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City | LA VERNE
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State | CA
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Zip | 91750-2353
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Country | US
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Telephone | 310-562-6375
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-11-8462
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License Number State | CA
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