Healthcare Provider Details

I. General information

NPI: 1982523346
Provider Name (Legal Business Name): CHLOE DEMORE RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 CALLE AVANZADO
SAN CLEMENTE CA
92673-6351
US

IV. Provider business mailing address

1319 CALLE AVANZADO
SAN CLEMENTE CA
92673-6351
US

V. Phone/Fax

Practice location:
  • Phone: 949-272-6146
  • Fax: 888-874-8864
Mailing address:
  • Phone: 949-272-6146
  • Fax: 888-874-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2828802
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: