Provider Demographics
NPI:1700105186
Name:CHAPIN, MALLORY ANTONINA (CD (CBI))
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:ANTONINA
Last Name:CHAPIN
Suffix:
Gender:F
Credentials:CD (CBI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7834 NYE DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-4378
Mailing Address - Country:US
Mailing Address - Phone:909-961-4256
Mailing Address - Fax:
Practice Address - Street 1:7834 NYE DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-4378
Practice Address - Country:US
Practice Address - Phone:909-961-4256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula