Individual
BETZABET CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335-4219
(909) 630-1956
Mailing address
233 BASELINE RD, LA VERNE, CA 91750-2353
(909) 833-2986
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/25/2016
Last updated
05/30/2023
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