Individual
RANDY CHAVEZ
Active
Individual
RANDY CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95382610
CA
167G00000X
Licensed Psychiatric Technician
Primary
35976
CA
Other
Enumeration date
09/29/2022
Last updated
06/12/2026
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