Provider Demographics
NPI:1982028510
Name:CHAVEZ, RHONDA (CS PROGRAM SUPPORT)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:CS PROGRAM SUPPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 COORS BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1213
Mailing Address - Country:US
Mailing Address - Phone:505-338-3320
Mailing Address - Fax:
Practice Address - Street 1:501 S 4TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:NM
Practice Address - Zip Code:88435-2417
Practice Address - Country:US
Practice Address - Phone:575-472-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor