Provider Demographics
NPI:1841391885
Name:CHELEC, SUSAN ROWAN (MSPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ROWAN
Last Name:CHELEC
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5656
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93150-5656
Mailing Address - Country:US
Mailing Address - Phone:805-565-5252
Mailing Address - Fax:805-565-5250
Practice Address - Street 1:1470 E VALLEY RD
Practice Address - Street 2:M
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-1220
Practice Address - Country:US
Practice Address - Phone:805-565-5252
Practice Address - Fax:805-565-5250
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7940208100000X
CA42179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT42179OtherCALIFORNIA LICENSE NUMBER