Provider Demographics
NPI:1457977811
Name:EASLEY BOSLEY, CHASTITY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHASTITY
Middle Name:
Last Name:EASLEY BOSLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 HARBOR BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-3828
Mailing Address - Country:US
Mailing Address - Phone:530-378-9415
Mailing Address - Fax:
Practice Address - Street 1:1550 HARBOR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-3828
Practice Address - Country:US
Practice Address - Phone:530-378-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program