Healthcare Provider Details

I. General information

NPI: 1952606527
Provider Name (Legal Business Name): CHANDRA NICOLE MCATEE M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3257 CAMINO DE LOS COCHES SUITE 203
CARLSBAD CA
92009-8976
US

IV. Provider business mailing address

6116 SUNSET CREST WAY
SAN DIEGO CA
92121-4126
US

V. Phone/Fax

Practice location:
  • Phone: 858-229-4199
  • Fax:
Mailing address:
  • Phone: 858-229-4199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number9707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: