Provider Demographics
NPI:1386182400
Name:MERRY, CHANDRA (PSYD, MA)
Entity Type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:
Last Name:MERRY
Suffix:
Gender:F
Credentials:PSYD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY NEW MEXICO MSC09-5030 UNIVERSITY OF NEW
Mailing Address - Street 2:MEXICO HEALTH SCIENCES CENTER DEPARTMENT OF PSYCHIATRY
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:510-548-9716
Mailing Address - Fax:510-841-1284
Practice Address - Street 1:1000 W CARSON ST # 488
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:424-306-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program