Provider Demographics
NPI:1053594200
Name:UBERMAN, CHERYL JAN (RN,MSN,CNS,APRN-BC,)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:JAN
Last Name:UBERMAN
Suffix:
Gender:F
Credentials:RN,MSN,CNS,APRN-BC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 QUARRY CT APT 208
Mailing Address - Street 2:
Mailing Address - City:POINT RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-4154
Mailing Address - Country:US
Mailing Address - Phone:510-235-2069
Mailing Address - Fax:415-289-1130
Practice Address - Street 1:1301 QUARRY CT APT 208
Practice Address - Street 2:
Practice Address - City:POINT RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-4154
Practice Address - Country:US
Practice Address - Phone:510-235-2069
Practice Address - Fax:415-289-1130
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 17421363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health