Provider Demographics
NPI:1255843124
Name:CHAPA, CASSANDRA LAUREN
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LAUREN
Last Name:CHAPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1978 DONALDSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-4169
Mailing Address - Country:US
Mailing Address - Phone:210-638-1566
Mailing Address - Fax:
Practice Address - Street 1:1978 DONALDSON AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-4169
Practice Address - Country:US
Practice Address - Phone:210-638-1566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician