MEDICARE: CORRI CHADWICK

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
1	106H00000X	Marriage & Family Therapist	50254	CA

General Provider Information

NPI Number	:	1417088485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORRI CHADWICK

Provider Business Mailing Address
First Line	:	6615 VALLEY HI DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-7076
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6615 VALLEY HI DR
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-7076
Country	:	US
Telephone Number	:	916-681-6300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	09/26/2011

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Directions to “ CORRI CHADWICK ” Practice Location

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