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General NPI Number Information
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NPI Number | 1124613021
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Entity Type | Individual
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Provider Name | EVELYN CHAVEZ
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Gender | Female
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 3605 LONG BEACH BLVD STE 330A
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City | LONG BEACH
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State | CA
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Zip | 90807-4013
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Country | US
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Telephone | 213-533-9224
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Fax |
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Provider Business Mailing Address
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Address Line | 110 W 6TH ST UNIT 262
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City | AZUSA
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State | CA
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Zip | 91702-6726
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT156061
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APCC19874
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License Number State | CA
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