Provider Demographics
NPI:1265848022
Name:CHINCHILLA, TRITIA KRISTIN (LMFT)
Entity Type:Individual
Prefix:
First Name:TRITIA KRISTIN
Middle Name:
Last Name:CHINCHILLA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TRITIA
Other - Middle Name:
Other - Last Name:MACARANAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:3817 CASTALA DR
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2582
Mailing Address - Country:US
Mailing Address - Phone:661-406-1854
Mailing Address - Fax:
Practice Address - Street 1:23236 LYONS AVE STE 212
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-5014
Practice Address - Country:US
Practice Address - Phone:661-406-1854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT112306106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist