Healthcare Provider Details

I. General information

NPI: 1851245526
Provider Name (Legal Business Name): CHELSEA JUSTINE MATZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10355 LOMA LN
SPRING VALLEY CA
91978-1517
US

IV. Provider business mailing address

166 CAMINO VISTA REAL
CHULA VISTA CA
91910-6260
US

V. Phone/Fax

Practice location:
  • Phone: 619-668-5700
  • Fax:
Mailing address:
  • Phone: 619-668-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLEP4065
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: