Individual
AMANDA MARIE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 ELM LN UNIT B, LOMPOC, CA 93436-2726
(909) 456-4046
Mailing address
220 ELM LN UNIT B, LOMPOC, CA 93436-2726
(909) 456-4046
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY35491
CA
Other
Enumeration date
02/06/2025
Last updated
02/06/2025
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