Healthcare Provider Details

I. General information

NPI: 1871415331
Provider Name (Legal Business Name): CHELSEA DE GOEDE LEP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 ECHO VALLEY RD
SALINAS CA
93907-9209
US

IV. Provider business mailing address

PO BOX 1023
CASTROVILLE CA
95012-1023
US

V. Phone/Fax

Practice location:
  • Phone: 805-710-7678
  • Fax:
Mailing address:
  • Phone: 805-710-7678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLEP4872
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: