Individual
CHERYL WOOTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17270 ROOSEVELT ST, RIVERSIDE, CA 92508-9523
(909) 522-9108
Mailing address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
167G00000X
Licensed Psychiatric Technician
Primary
28139
CA
167G00000X
Licensed Psychiatric Technician
—
—
Other
Enumeration date
08/07/2019
Last updated
12/07/2023
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