Provider Demographics
NPI:1578223103
Name:CHATELLE-BERGMAN, BABETTE ANGELA (MA)
Entity Type:Individual
Prefix:
First Name:BABETTE
Middle Name:ANGELA
Last Name:CHATELLE-BERGMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:BABETTE
Other - Middle Name:ANGELA
Other - Last Name:CHATELLE-BERGMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:24275 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-7285
Mailing Address - Country:US
Mailing Address - Phone:951-677-5599
Mailing Address - Fax:
Practice Address - Street 1:22877 SWEETBAY DR
Practice Address - Street 2:
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-8667
Practice Address - Country:US
Practice Address - Phone:951-615-7499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14109101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional