Basic Information
| Provider Information | |||||||||
| NPI: | 1730243742 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAVEZ | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 N BEWLEY ST | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927033313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147216980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 303 W LINCOLN AVE STE 130 | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928052993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145207300 | ||||||||
| FaxNumber: | 7145200883 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2006 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | LMFT127153 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.