Provider Demographics
NPI:1871158824
Name:MENA, CHELSEE J (MS)
Entity type:Individual
Prefix:
First Name:CHELSEE
Middle Name:J
Last Name:MENA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15992 JAMIE LN UNIT 9
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-6164
Mailing Address - Country:US
Mailing Address - Phone:909-749-5204
Mailing Address - Fax:
Practice Address - Street 1:15992 JAMIE LN UNIT 9
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-6164
Practice Address - Country:US
Practice Address - Phone:909-749-5204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst