Provider Demographics
NPI:1023344819
Name:CHAVEZ, KAREM DALISAY (SLP)
Entity type:Individual
Prefix:
First Name:KAREM
Middle Name:DALISAY
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6089 MADELAINE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1731
Mailing Address - Country:US
Mailing Address - Phone:510-877-0686
Mailing Address - Fax:
Practice Address - Street 1:6089 MADELAINE DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1731
Practice Address - Country:US
Practice Address - Phone:510-375-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist