Individual
ANDREA CRUZ CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1550 HOTEL CIR N STE 270, SAN DIEGO, CA 92108-2908
(619) 814-6494
(619) 528-4625
Mailing address
PSYCHIATRIC CENTERS AT SAN DIEGO, PO BOX 609001, SAN DIEGO, CA 92160-9001
(619) 528-4600
(619) 528-4625
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W416
PCSD MEDICARE
—
Enumeration date
03/06/2019
Last updated
11/29/2021
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