Healthcare Provider Details

I. General information

NPI: 1497683593
Provider Name (Legal Business Name): MRS. MICKELIA DONNA-DEAN CHAMBERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. MICKELIA WILLIAMS

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W B ST
SAN DIEGO CA
92101-3539
US

IV. Provider business mailing address

1140 VIA PINTURA APT 302
CHULA VISTA CA
91913-0026
US

V. Phone/Fax

Practice location:
  • Phone: 713-835-9162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: