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NPI Code Detail

MEDICARE: CHELSIE RENEE GORDON

MEDICARE: CHELSIE RENEE GORDON
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) CounselorCA

General Provider Information

NPI Number : 1346600384
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSIE RENEE GORDON
Provider Business Mailing Address
First Line : 4281 KATELLA AVE STE 117
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-3590
Country : US
Telephone Number : 562-594-8844
Fax Number : 562-248-0477
Provider Business Practice Location Address
First Line : 4281 KATELLA AVE STE 117
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-3590
Country : US
Telephone Number : 562-594-8844
Fax Number : 562-248-0477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2016
Last Update Date : 02/09/2022

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Directions to “ CHELSIE RENEE GORDON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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