MEDICARE: CHELSEY DAVEKOS

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	104100000X	Social Worker
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1952682841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEY DAVEKOS

Provider Business Mailing Address
First Line	:	969 S SANTA FE AVE STE C
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92083-6910
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	969 S SANTA FE AVE STE C
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92083-6910
Country	:	US
Telephone Number	:	760-294-1188
Fax Number	:

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

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	02/03/2022

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Directions to “ CHELSEY DAVEKOS ” Practice Location

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