Provider Demographics
NPI:1700641685
Name:CHEMERY, DEEPA
Entity Type:Individual
Prefix:
First Name:DEEPA
Middle Name:
Last Name:CHEMERY
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 1:6355 DE SOTO AVE APT A324
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2630
Mailing Address - Country:US
Mailing Address - Phone:818-805-6803
Mailing Address - Fax:
Practice Address - Street 1:24903 PACIFIC COAST HWY STE 102
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-4734
Practice Address - Country:US
Practice Address - Phone:310-310-9249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG