Provider Demographics
NPI:1780772483
Name:CHAVEZ, ANTHONY EUGENE (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:EUGENE
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14035 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2016
Mailing Address - Country:US
Mailing Address - Phone:562-945-9486
Mailing Address - Fax:
Practice Address - Street 1:10355 SLUSHER DR
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-7353
Practice Address - Country:US
Practice Address - Phone:562-903-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 93631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical