Provider Demographics
NPI:1134487077
Name:CHALMERS, ELDEN VERLIN (MFT)
Entity Type:Individual
Prefix:
First Name:ELDEN
Middle Name:VERLIN
Last Name:CHALMERS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 DIABLO RD APT A
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-2021
Mailing Address - Country:US
Mailing Address - Phone:925-216-1368
Mailing Address - Fax:
Practice Address - Street 1:2050 DIABLO RD APT A
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-2021
Practice Address - Country:US
Practice Address - Phone:925-216-1368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-29
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMV18244101YA0400X, 101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst