Healthcare Provider Details

I. General information

NPI: 1790689966
Provider Name (Legal Business Name): CARALYN CHESNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARA CHESNEY

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9295 FARNHAM ST STE 200
SAN DIEGO CA
92123-1255
US

IV. Provider business mailing address

8668 CHANTILLY AVE
SAN DIEGO CA
92123-3435
US

V. Phone/Fax

Practice location:
  • Phone: 858-332-2631
  • Fax:
Mailing address:
  • Phone: 858-395-1816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: