Healthcare Provider Details

I. General information

NPI: 1295978849
Provider Name (Legal Business Name): CHELSIE M BORDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25186 HANCOCK AVE #100
MURRIETA CA
92562-5998
US

IV. Provider business mailing address

25186 HANCOCK AVE #100
MURRIETA CA
92562-5998
US

V. Phone/Fax

Practice location:
  • Phone: 951-698-8558
  • Fax:
Mailing address:
  • Phone: 951-698-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: