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General NPI Number Information
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NPI Number | 1205551827
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Entity Type | Organization
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Legal Business Name | CHASTELLA INC
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 13530 SYLMAR DR
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3421
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Country | US
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Telephone | 951-653-6958
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1170
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City | MORENO VALLEY
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State | CA
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Zip | 92556-1170
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Country | US
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Telephone | 909-370-2858
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Fax |
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Authorized Official
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Title or Position | QA CLINICAL MANAGER
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Name | FRANCES OHAERI
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Credential | LCSW
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Telephone | 909-649-6111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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