Provider Demographics
NPI:1053548768
Name:MEICHTRY, CHERISSE (MS, ATC, PES)
Entity type:Individual
Prefix:
First Name:CHERISSE
Middle Name:
Last Name:MEICHTRY
Suffix:
Gender:F
Credentials:MS, ATC, PES
Other - Prefix:
Other - First Name:CHERISSE
Other - Middle Name:
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC, PES
Mailing Address - Street 1:7075 CAMPUS RD
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1605
Mailing Address - Country:US
Mailing Address - Phone:805-378-1493
Mailing Address - Fax:
Practice Address - Street 1:7075 CAMPUS RD
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1605
Practice Address - Country:US
Practice Address - Phone:805-378-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-20
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer