Individual
CARLOS CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 517-2368
Mailing address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 517-2368
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37203
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11241000383
—
CA
Enumeration date
06/09/2014
Last updated
04/21/2025
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