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
—
—
Other
Enumeration date
05/21/2022
Last updated
05/21/2022
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