Provider Demographics
NPI:1508068651
Name:CHYETTE, DENISE (DPT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:CHYETTE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N SEPULVEDA BLVD
Mailing Address - Street 2:# 200
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2902
Mailing Address - Country:US
Mailing Address - Phone:310-750-5216
Mailing Address - Fax:
Practice Address - Street 1:815 MANHATTAN AVE. SUITE B
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266
Practice Address - Country:US
Practice Address - Phone:310-750-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA32009OtherPHYSICAL THERAPIST LICENS
CAWPT32009AMedicare PIN