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NPI Code Detail

MEDICARE: BETZABET CHAVEZ

MEDICARE: BETZABET CHAVEZ
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
1225400000XRehabilitation Practitioner
2101YM0800XMental Health CounselorCA
3101Y00000XCounselor

General Provider Information

NPI Number : 1619339876
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETZABET CHAVEZ
Provider Business Mailing Address
First Line : 233 BASELINE RD
Second Line :
City : LA VERNE
State : CA
Zip : 91750-2353
Country : US
Telephone Number : 909-833-2986
Fax Number :
Provider Business Practice Location Address
First Line : 14677 MERRILL AVE
Second Line :
City : FONTANA
State : CA
Zip : 92335-4219
Country : US
Telephone Number : 909-630-1956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2016
Last Update Date : 05/30/2023

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Directions to “ BETZABET CHAVEZ ” Practice Location

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