Healthcare Provider Details

I. General information

NPI: 1164346995
Provider Name (Legal Business Name): JOANA CHAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 FULTON AVE STE 160
SACRAMENTO CA
95825-4517
US

IV. Provider business mailing address

5943 13TH AVE
SACRAMENTO CA
95820-2403
US

V. Phone/Fax

Practice location:
  • Phone: 916-426-6567
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: