Provider Demographics
NPI:1710272232
Name:CASEY, CHERYL DENISE (MS)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:DENISE
Last Name:CASEY
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 E DYER RD STE 135
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5643
Mailing Address - Country:US
Mailing Address - Phone:714-944-6870
Mailing Address - Fax:714-659-6379
Practice Address - Street 1:3230 E IMPERIAL HWY STE 300
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6751
Practice Address - Country:US
Practice Address - Phone:562-331-7414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X, 390200000X
CA99370106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program