Provider Demographics
NPI:1376889865
Name:CHAVEZ, MEGAN ELANA
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ELANA
Last Name:CHAVEZ
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 1:5784 W WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-0462
Mailing Address - Country:US
Mailing Address - Phone:559-301-3036
Mailing Address - Fax:
Practice Address - Street 1:5784 W WILLIS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-0462
Practice Address - Country:US
Practice Address - Phone:559-301-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program