Individual
ANGELA TILATHA CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4139 EL CAMINO WAY, PALO ALTO, CA 94306-4010
(650) 999-7069
(408) 642-6052
Mailing address
1922 THE ALAMEDA STE 316, SAN JOSE, CA 95126-1461
(408) 261-7777
(408) 642-6052
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1346528106
CA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346528106
—
CA
Enumeration date
06/07/2019
Last updated
04/18/2024
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