Provider Demographics
NPI:1033363759
Name:WEISING, CHANDRA NEWMARK (LCSW)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:NEWMARK
Last Name:WEISING
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:PO BOX 7672
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93006-7672
Mailing Address - Country:US
Mailing Address - Phone:805-340-1689
Mailing Address - Fax:
Practice Address - Street 1:4050 MARKET ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5625
Practice Address - Country:US
Practice Address - Phone:805-654-1422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA247461041C0700X
MA1114331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical