Provider Demographics
NPI:1457590085
Name:CHOMISTEK, PAULA ELAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ELAINE
Last Name:CHOMISTEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 PROVIDENCE MINE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2947
Mailing Address - Country:US
Mailing Address - Phone:530-265-7844
Mailing Address - Fax:
Practice Address - Street 1:202 PROVIDENCE MINE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2947
Practice Address - Country:US
Practice Address - Phone:530-265-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 295801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical