Provider Demographics
NPI:1609688191
Name:CHAVEZ, JEANETTE CHRISTINE
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:CHRISTINE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18325 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4425
Mailing Address - Country:US
Mailing Address - Phone:818-330-3337
Mailing Address - Fax:818-745-3337
Practice Address - Street 1:18325 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4425
Practice Address - Country:US
Practice Address - Phone:818-330-3337
Practice Address - Fax:818-745-3337
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist