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General NPI Number Information
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NPI Number | 1023788965
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Entity Type | Individual
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Provider Name | LUIS A CHAVEZ RODRIGUEZ APCC 10063
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Gender | Male
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 1161 BAY BLVD STE B
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City | CHULA VISTA
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State | CA
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Zip | 91911-2670
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Country | US
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Telephone | 619-585-7686
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Fax | 619-585-7699
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Provider Business Mailing Address
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Address Line | 817 ETA ST APT 1707
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City | NATIONAL CITY
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State | CA
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Zip | 91950-1425
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Country | US
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Telephone | 619-581-7010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10063
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License Number State | CA
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