Healthcare Provider Details

I. General information

NPI: 1689453987
Provider Name (Legal Business Name): TAYNA MONIQUE CHESSMAN LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35851 LOURDES DR
WINCHESTER CA
92596-9148
US

IV. Provider business mailing address

35851 LOURDES DR
WINCHESTER CA
92596-9148
US

V. Phone/Fax

Practice location:
  • Phone: 562-754-1320
  • Fax:
Mailing address:
  • Phone: 562-754-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number784
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: