=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851943336
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHANTELLE THERESE MALABANAN LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2019
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23181 VERDUGO DR STE 105B
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653-1313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-520-2720
-----------------------------------------------------
Fax | 949-215-4413
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23152 VERDUGO DR STE 105
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653-1373
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-520-2720
-----------------------------------------------------
Fax | 949-215-4413
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 132565
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------