Provider Demographics
NPI:1780876276
Name:CHAVES, HERNANDO
Entity type:Individual
Prefix:MR
First Name:HERNANDO
Middle Name:
Last Name:CHAVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N ROBERTSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-5022
Mailing Address - Country:US
Mailing Address - Phone:310-358-8727
Mailing Address - Fax:310-358-8721
Practice Address - Street 1:5724 W 3RD ST
Practice Address - Street 2:#307
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3078
Practice Address - Country:US
Practice Address - Phone:323-456-0801
Practice Address - Fax:323-456-0805
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist