Provider Demographics
NPI:1801401260
Name:CHAVERS, JAMES JR (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:CHAVERS
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 CHERRY DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2150
Mailing Address - Country:US
Mailing Address - Phone:626-487-7609
Mailing Address - Fax:
Practice Address - Street 1:335 CHERRY DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2150
Practice Address - Country:US
Practice Address - Phone:626-487-7609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY32025103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical