Healthcare Provider Details

I. General information

NPI: 1568376861
Provider Name (Legal Business Name): CHASE SUMMERS LICENSED CLINICAL SOCIAL WORKER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8919 GARVEY AVE STE C2A133
ROSEMEAD CA
91770-3376
US

IV. Provider business mailing address

8919 GARVEY AVE STE C2A133
ROSEMEAD CA
91770-3376
US

V. Phone/Fax

Practice location:
  • Phone: 805-380-6724
  • Fax:
Mailing address:
  • Phone: 805-380-6724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. CHASE BRAYDEN SUMMERS
Title or Position: CLINIICAL SOCIAL WORKER
Credential: LCSW
Phone: 805-380-6724