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NPI Code Detail

MEDICARE: CHELSEA GATDULA RADT

MEDICARE: CHELSEA GATDULA RADT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorR1398710720CA

General Provider Information

NPI Number : 1033871348
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA GATDULA RADT
Provider Business Mailing Address
First Line : 2750 S HARBOR BLVD STE G
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-5820
Country : US
Telephone Number : 866-746-1558
Fax Number :
Provider Business Practice Location Address
First Line : 2750 S HARBOR BLVD STE G
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-5820
Country : US
Telephone Number : 866-746-1558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2021
Last Update Date : 10/13/2021

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Directions to “ CHELSEA GATDULA RADT” Practice Location

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