Provider Demographics
NPI:1265839138
Name:CHAVES, FRANCISCO (PHD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:CHAVES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 E COLORADO BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2028
Mailing Address - Country:US
Mailing Address - Phone:626-788-1978
Mailing Address - Fax:
Practice Address - Street 1:595 E COLORADO BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2028
Practice Address - Country:US
Practice Address - Phone:626-788-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27569103TP2701X, 103TE1100X, 103TC0700X
CAPSB 94020704103T00000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103T00000XBehavioral Health & Social Service ProvidersPsychologist