Provider Demographics
NPI:1639314909
Name:MOREHEAD, CHELSIE LEE (ATC)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:LEE
Last Name:MOREHEAD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2748 LARAMIE GATE CIR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4569
Mailing Address - Country:US
Mailing Address - Phone:209-914-4276
Mailing Address - Fax:
Practice Address - Street 1:43600 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5847
Practice Address - Country:US
Practice Address - Phone:510-659-6501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program