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NPI Code Detail

MEDICARE: JEANETTE CHAVEZ PEER SUPPORT

MEDICARE: JEANETTE CHAVEZ PEER SUPPORT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1215691894
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE CHAVEZ PEER SUPPORT
Provider Business Mailing Address
First Line : 336 OXFORD ST STE 209
Second Line :
City : CHULA VISTA
State : CA
Zip : 91911-3122
Country : US
Telephone Number : 619-691-1662
Fax Number : 619-839-3718
Provider Business Practice Location Address
First Line : 336 OXFORD ST STE 209
Second Line :
City : CHULA VISTA
State : CA
Zip : 91911-3122
Country : US
Telephone Number : 619-691-1662
Fax Number : 619-839-3718
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2021
Last Update Date : 10/28/2021

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Directions to “ JEANETTE CHAVEZ PEER SUPPORT” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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