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Organization
DR. NICOLE CHAVEZ PSYCHOLOGICAL SERVICES P.C.
Active
Organization
DR. NICOLE CHAVEZ PSYCHOLOGICAL SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE CHAVEZ PSY.D. (CEO)
(949) 280-4685
Entity
Organization
Contact information
Practice address
427 E 17TH ST # STF-1112, COSTA MESA, CA 92627-3201
(949) 280-4685
Mailing address
1555 MESA VERDE DR E APT 40K, COSTA MESA, CA 92626-5246
(949) 280-4685
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
05/21/2022
Last updated
05/21/2022
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