Individual
JESUS CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
323 N PRAIRIE AVE, INGLEWOOD, CA 90301-4502
(310) 846-2100
(310) 846-2139
Mailing address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 390-6612
(310) 398-5690
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/23/2017
Last updated
08/27/2019
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