Individual
GORDON CHAVEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 W HENDERSON AVE STE 2, PORTERVILLE, CA 93257-1490
(559) 788-1200
Mailing address
1055 W HENDERSON AVE STE 2, PORTERVILLE, CA 93257-1490
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT34762
CA
Other
Enumeration date
07/01/2021
Last updated
07/12/2021
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