Individual
MRS. ANA LUISA CHAVEZ-MANCILLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACSW
Contact information
Practice address
1126 N GRAND AVE, COVINA, CA 91724-1551
(626) 967-1667
(626) 967-6027
Mailing address
1126 N GRAND AVE, COVINA, CA 91724-1551
(626) 967-1667
(626) 967-6027
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
29534
CA
101YM0800X
Mental Health Counselor
Primary
ASW74655
—
101YP1600X
Pastoral Counselor
—
CA
225400000X
Rehabilitation Practitioner
—
CA
Other
Enumeration date
02/07/2007
Last updated
03/16/2022
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