Individual
LATISHA ANN CHAPPELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335-4219
(951) 643-2340
Mailing address
14677 MERRILL AVE, FONTANA, CA 92335-4219
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36942
CA
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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