Healthcare Provider Details
I. General information
NPI: 1144012931
Provider Name (Legal Business Name): KARINA CHAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1360 E LASSEN AVE
CHICO CA
95973-7823
US
IV. Provider business mailing address
83 TRAVERTINE CT
LATHROP CA
95330-8828
US
V. Phone/Fax
- Phone: 530-893-0758
- Fax:
- Phone: 209-221-2416
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: