Provider Demographics
NPI:1942324355
Name:CHAPPEL, SALLY J (MFT)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:J
Last Name:CHAPPEL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MOWRY AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1531
Mailing Address - Country:US
Mailing Address - Phone:510-494-1400
Mailing Address - Fax:
Practice Address - Street 1:3100 MOWRY AVE STE 301
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1531
Practice Address - Country:US
Practice Address - Phone:510-494-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 38862106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist