Provider Demographics
NPI:1437331345
Name:CHAMBERLIN, JUDITH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:CHAMBERLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:17752 SKY PARK CIR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6419
Mailing Address - Country:US
Mailing Address - Phone:949-292-2092
Mailing Address - Fax:949-587-2815
Practice Address - Street 1:17752 SKY PARK CIR
Practice Address - Street 2:SUITE 260
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6419
Practice Address - Country:US
Practice Address - Phone:949-292-2092
Practice Address - Fax:949-587-2815
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 266651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical