Healthcare Provider Details

I. General information

NPI: 1912802026
Provider Name (Legal Business Name): VIRGINIA CHAVEZ PROFESSIONAL CLINICAL COUNSELOR AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28005 SMYTH DR STE 121
VALENCIA CA
91355-4023
US

IV. Provider business mailing address

28005 SMYTH DR STE 121
VALENCIA CA
91355-4023
US

V. Phone/Fax

Practice location:
  • Phone: 805-263-7765
  • Fax:
Mailing address:
  • Phone: 805-263-7765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: VIRGINIA CHAVEZ
Title or Position: OWNER
Credential: LPCC, LMHC
Phone: 805-263-7765