MEDICARE: LISA RACHEL CHESTER-SCHYMAN

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
1	106H00000X	Marriage & Family Therapist	136293	CA

General Provider Information

NPI Number	:	1235843582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA RACHEL CHESTER-SCHYMAN

Provider Business Mailing Address
First Line	:	4842 SALEM VILLAGE PL
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4324
Country	:	US
Telephone Number	:	310-528-9082
Fax Number	:

Provider Business Practice Location Address
First Line	:	4842 SALEM VILLAGE PL
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-4324
Country	:	US
Telephone Number	:	310-528-9082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	01/11/2023

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