Healthcare Provider Details

I. General information

NPI: 1720719669
Provider Name (Legal Business Name): CHAPMAN HEALTH & WELLNESS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 N HOLLYWOOD WAY
BURBANK CA
91505-1520
US

IV. Provider business mailing address

2010 N HOLLYWOOD WAY
BURBANK CA
91505-1520
US

V. Phone/Fax

Practice location:
  • Phone: 818-321-1095
  • Fax:
Mailing address:
  • Phone: 818-321-1095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TISTO CHAPMAN
Title or Position: OWNER
Credential:
Phone: 818-321-1095