Provider Demographics
NPI:1932478302
Name:CHESTER, JAIME A
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:A
Last Name:CHESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 W PINNACLE PEAK RD STE 360
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1230
Mailing Address - Country:US
Mailing Address - Phone:602-525-2018
Mailing Address - Fax:029-262-2386
Practice Address - Street 1:2222 W PINNACLE PEAK RD STE 360
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1230
Practice Address - Country:US
Practice Address - Phone:602-525-2018
Practice Address - Fax:029-262-2386
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21014101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health