Healthcare Provider Details

I. General information

NPI: 1346583010
Provider Name (Legal Business Name): CHELSEA ANGELA SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2013
Last Update Date: 02/18/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 S BROADWAY
LOS ANGELES CA
90037-4131
US

IV. Provider business mailing address

5715 S BROADWAY
LOS ANGELES CA
90037-4131
US

V. Phone/Fax

Practice location:
  • Phone: 310-245-8992
  • Fax:
Mailing address:
  • Phone: 310-245-8992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: