Healthcare Provider Details

I. General information

NPI: 1205100419
Provider Name (Legal Business Name): CHELSEA SLEETH MOYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA SLEETH

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 HIGHWAY 9 STE 204
FELTON CA
95018-9711
US

IV. Provider business mailing address

1116 LAKESIDE DR
FELTON CA
95018-9649
US

V. Phone/Fax

Practice location:
  • Phone: 831-222-0744
  • Fax:
Mailing address:
  • Phone: 831-222-0744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number97988
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number97988
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number97988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: