MEDICARE: TERESA JO CHERRY AASSLPA

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	2355S0801X	Speech-Language Assistant	5495	CA

General Provider Information

NPI Number	:	1962350058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA JO CHERRY AASSLPA

Provider Business Mailing Address
First Line	:	901 MYRTLE AVE
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-1219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 MYRTLE AVE
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-1219
Country	:	US
Telephone Number	:	707-445-7068
Fax Number	:

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

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/27/2026

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Directions to “ TERESA JO CHERRY AASSLPA” Practice Location

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