Healthcare Provider Details

I. General information

NPI: 1851082234
Provider Name (Legal Business Name): CASSANDRA ANN CHATMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1667 S MISSION RD STE C
FALLBROOK CA
92028-4119
US

IV. Provider business mailing address

1667 S MISSION RD STE C
FALLBROOK CA
92028-4119
US

V. Phone/Fax

Practice location:
  • Phone: 760-286-7774
  • Fax:
Mailing address:
  • Phone: 760-286-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT149271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: