Healthcare Provider Details

I. General information

NPI: 1841048014
Provider Name (Legal Business Name): RHIYANNA CHATTA CPT, EIM, OES
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 SYCAMORE AVE
VISTA CA
92083
US

IV. Provider business mailing address

615 SYCAMORE AVE
VISTA CA
92083
US

V. Phone/Fax

Practice location:
  • Phone: 858-247-2417
  • Fax: 858-788-0497
Mailing address:
  • Phone: 858-247-2417
  • Fax: 858-788-0497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: