MEDICARE: DR. ROXANNE S CHERRY PH.D. MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	22810	CA

General Provider Information

NPI Number	:	1124046297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROXANNE S CHERRY PH.D. MFT

Provider Business Mailing Address
First Line	:	29245 POMPANO WAY
Second Line	:
City	:	LAGUNA NIGUEL
State	:	CA
Zip	:	92677-1674
Country	:	US
Telephone Number	:	949-228-2844
Fax Number	:	949-497-4324

Provider Business Practice Location Address
First Line	:	27281 LAS RAMBLAS STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-8303
Country	:	US
Telephone Number	:	949-228-2844
Fax Number	:	949-497-4324

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	05/29/2025

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