Provider Demographics
NPI:1821762824
Name:CHAVEZ, VANESSA ROCHELLE (CSW)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:ROCHELLE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 LAKE DR
Mailing Address - Street 2:1004 CINNAMON LOOP APT 17
Mailing Address - City:SANTA ROSA
Mailing Address - State:NM
Mailing Address - Zip Code:88435
Mailing Address - Country:US
Mailing Address - Phone:575-512-5425
Mailing Address - Fax:
Practice Address - Street 1:1047 LAKE DR
Practice Address - Street 2:1004 CINNAMON LOOP APT 17
Practice Address - City:SANTA ROSA
Practice Address - State:NM
Practice Address - Zip Code:88435
Practice Address - Country:US
Practice Address - Phone:575-512-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor