Provider Demographics
NPI:1861042756
Name:CHAVOYA, VENESSA (MA, BA)
Entity Type:Individual
Prefix:
First Name:VENESSA
Middle Name:
Last Name:CHAVOYA
Suffix:
Gender:F
Credentials:MA, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11721 TELEGRAPH RD STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-6835
Mailing Address - Country:US
Mailing Address - Phone:562-949-8455
Mailing Address - Fax:
Practice Address - Street 1:11721 TELEGRAPH RD STE A
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-6835
Practice Address - Country:US
Practice Address - Phone:562-949-8445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator