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Individual

MS. THERESA MARY GABRIELLE CHERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CTRS

Contact information

Practice address
1433 6TH ST, APT F, SANTA MONICA, CA 90401-2554
(310) 488-1232
Mailing address
1433 6TH ST, APT F, SANTA MONICA, CA 90401-2554
(310) 488-1232

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
41502
CA
174400000X
Specialist
41502
CA
225800000X
Recreation Therapist
Primary
41502
CA

Other

Enumeration date
08/07/2012
Last updated
05/01/2015
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