Individual
AJA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 DOVE ST STE 215, NEWPORT BEACH, CA 92660-2848
(949) 531-2776
Mailing address
1001 DOVE ST STE 215, NEWPORT BEACH, CA 92660-2848
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A049240318
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A049240318
CADC CREDENTIAL
CA
Enumeration date
10/12/2019
Last updated
10/12/2019
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