Cheryll La Vonne Putt, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC39494 Issued in CA

Practice address

1371 Corte Bagalso
San Marcos, CA 92069-7392

Phone

(858) 603-5759

Fax

(858) 451-9929

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1699891754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16776 BERNARDO CENTER DR",
            "address_2": "SUITE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282534",
            "telephone_number": "858-451-9929",
            "fax_number": "858-451-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 CORTE BAGALSO",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920697392",
            "telephone_number": "858-603-5759",
            "fax_number": "858-451-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTT",
        "first_name": "CHERYLL",
        "middle_name": "LA VONNE",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC39494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.