Provider Demographics
NPI:1144111998
Name:CHAVEZ, JOSE M (EDD, BCET, ADHD-CE)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:EDD, BCET, ADHD-CE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 E 103RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002-3306
Mailing Address - Country:US
Mailing Address - Phone:323-564-7911
Mailing Address - Fax:323-569-8527
Practice Address - Street 1:1465 E 103RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3306
Practice Address - Country:US
Practice Address - Phone:323-564-7911
Practice Address - Fax:323-564-7911
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management