Provider Demographics
NPI:1447346523
Name:CHAIYAHAT, SIBELIA L (LCSW)
Entity type:Individual
Prefix:DR
First Name:SIBELIA
Middle Name:L
Last Name:CHAIYAHAT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 S. EL CAMINO REAL STE 206
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6280
Mailing Address - Country:US
Mailing Address - Phone:442-500-8548
Mailing Address - Fax:760-400-8379
Practice Address - Street 1:2103 S. EL CAMINO REAL STE 206
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6280
Practice Address - Country:US
Practice Address - Phone:442-500-8548
Practice Address - Fax:760-400-8379
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW646851041C0700X
OR36941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical