Individual
CHELSEY FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6022 VARIEL AVE, WOODLAND HILLS, CA 91367-3719
(818) 996-1051
Mailing address
18646 OXNARD ST, TARZANA, CA 91356-1411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1380690320
CA
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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