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NPI Code Detail

MEDICARE: DIANA CHAVEZ MA

MEDICARE: DIANA CHAVEZ MA
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
1106H00000XMarriage & Family Therapist115476CA
2106H00000XMarriage & Family Therapist93132CA

General Provider Information

NPI Number : 1619006046
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA CHAVEZ MA
Provider Business Mailing Address
First Line : 11601 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-5006
Country : US
Telephone Number : 323-242-5000
Fax Number :
Provider Business Practice Location Address
First Line : 11601 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-5006
Country : US
Telephone Number : 323-242-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 06/29/2020

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Directions to “ DIANA CHAVEZ MA” Practice Location

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