Provider Demographics
NPI:1821179078
Name:CHANDLER, NANCY BENITEZ (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:BENITEZ
Last Name:CHANDLER
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 1:19231 VICTORY BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6308
Mailing Address - Country:US
Mailing Address - Phone:818-708-4500
Mailing Address - Fax:818-654-1956
Practice Address - Street 1:19231 VICTORY BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6308
Practice Address - Country:US
Practice Address - Phone:818-708-4500
Practice Address - Fax:818-654-1956
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18340103TC0700X, 103TC2200X, 103TF0000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist