Healthcare Provider Details

I. General information

NPI: 1285180919
Provider Name (Legal Business Name): COURTNEY CHAPPELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E OLIVE AVE STE 540
BURBANK CA
91501-2132
US

IV. Provider business mailing address

500 E OLIVE AVE STE 540
BURBANK CA
91501-2132
US

V. Phone/Fax

Practice location:
  • Phone: 818-446-2522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY36397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: