Individual
NICOLAS PABLO CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 OFFICE COURT DR STE 706, SANTA FE, NM 87507-4958
(505) 395-9611
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
915204
UNITED HEALTHCARE
—
01
—
961528456
UNITED HEALTHCARE
NM
Enumeration date
11/05/2020
Last updated
11/05/2020
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