Provider Demographics
NPI:1437341179
Name:CHAPA-PADILLA, MARTHA CAROLINA
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:CAROLINA
Last Name:CHAPA-PADILLA
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 1:41690 ENTERPRISE CIR N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5616
Mailing Address - Country:US
Mailing Address - Phone:951-338-9769
Mailing Address - Fax:951-695-5236
Practice Address - Street 1:41690 ENTERPRISE CIR N
Practice Address - Street 2:SUITE 100
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5616
Practice Address - Country:US
Practice Address - Phone:951-338-9769
Practice Address - Fax:951-695-5236
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist