Individual provider Active NPI

Cheree Nichole Van Eyck

  • Clinical Social Worker
  • Redding, CA
National Provider Identifier
1154027001
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
97368 Issued in CA
Practice address
1441 Liberty St
Redding, CA 96001-0811
Phone
(530) 224-2700
Fax
(530) 224-2738
NPI assigned
Feb 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 97368 CA Primary

Addresses

Primary practice location

1441 Liberty St
Redding, CA 96001-0811

Mailing address

3862 Country Estates Dr
Cottonwood, CA 96022-9573
Phone (530) 356-0165

Other names 1

  • Cheree Nichole Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
97368CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1154027001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3862 COUNTRY ESTATES DR",
            "city": "COTTONWOOD",
            "state": "CA",
            "postal_code": "960229573",
            "telephone_number": "530-356-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010811",
            "telephone_number": "530-224-2700",
            "fax_number": "530-224-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN EYCK",
        "first_name": "CHEREE",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-02",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHEREE",
            "last_name": "SMITH",
            "middle_name": "NICHOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.