Individual
AMY CHAPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 W VISTA WAY, VISTA, CA 92083-5704
(916) 940-1274
Mailing address
504 W VISTA WAY, VISTA, CA 92083-5704
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D535849
MEDI-CAL
CA
Enumeration date
06/08/2022
Last updated
06/08/2022
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