Healthcare Provider Details

I. General information

NPI: 1467185801
Provider Name (Legal Business Name): CHANDLER GARRETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2022
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 SAN VICENTE BLVD STE 408
LOS ANGELES CA
90048-5462
US

IV. Provider business mailing address

4126 EMPIS ST
WOODLAND HILLS CA
91364-6007
US

V. Phone/Fax

Practice location:
  • Phone: 310-855-2229
  • Fax:
Mailing address:
  • Phone: 310-990-2967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95220748
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WR1000X
TaxonomyReproductive Endocrinology/Infertility Registered Nurse
License Number95220748
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number95220748
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number95033045
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95033045
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: