Provider Demographics
NPI:1437463304
Name:CHAVEZ, VERONICA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21081 S WESTERN AVE
Mailing Address - Street 2:SUITE 295
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1703
Mailing Address - Country:US
Mailing Address - Phone:310-533-6609
Mailing Address - Fax:310-787-9035
Practice Address - Street 1:21081 S WESTERN AVE
Practice Address - Street 2:SUITE 295
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1703
Practice Address - Country:US
Practice Address - Phone:310-533-6609
Practice Address - Fax:310-787-9035
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27929103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist