Provider Demographics
NPI:1023537628
Name:CHLADEK, ANDREA REBECCA (CNM)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:REBECCA
Last Name:CHLADEK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E TACHEVAH DR STE 2W103
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5748
Mailing Address - Country:US
Mailing Address - Phone:760-327-2707
Mailing Address - Fax:760-778-3780
Practice Address - Street 1:555 E TACHEVAH DR STE 2W103
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5748
Practice Address - Country:US
Practice Address - Phone:760-327-2707
Practice Address - Fax:760-327-0029
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235900176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife