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NPI Code Detail

MEDICARE: DR. CHERI DIANNE WHEELER PH.D.

MEDICARE:  DR. CHERI DIANNE WHEELER  PH.D.
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
1103TC0700XClinical Psychologist21392CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2OPL213920OTHERCABLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number : 1861615783
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHERI DIANNE WHEELER PH.D.
Provider Business Mailing Address
First Line : 2670 S WHITE RD
Second Line : SUITE 245
City : SAN JOSE
State : CA
Zip : 95148-2071
Country : US
Telephone Number : 408-833-5739
Fax Number : 408-528-8924
Provider Business Practice Location Address
First Line : 2670 S WHITE RD
Second Line : SUITE 245
City : SAN JOSE
State : CA
Zip : 95148-2071
Country : US
Telephone Number : 408-833-5739
Fax Number : 408-528-8939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 03/24/2008

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Directions to “ DR. CHERI DIANNE WHEELER PH.D.” Practice Location

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