Provider Demographics
NPI:1255574273
Name:WHITTLESEY, CHLOE
Entity type:Individual
Prefix:MISS
First Name:CHLOE
Middle Name:
Last Name:WHITTLESEY
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 1:126 W 25TH AVE
Mailing Address - Street 2:SUITE #202
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2208
Mailing Address - Country:US
Mailing Address - Phone:650-286-2090
Mailing Address - Fax:
Practice Address - Street 1:126 W 25TH AVENUE
Practice Address - Street 2:SUITE #202
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2208
Practice Address - Country:US
Practice Address - Phone:650-286-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist