Provider Demographics
NPI:1952673956
Name:CHAMBERS, KENT (LNHA)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:LNHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 ESPERANZA AVE
Mailing Address - Street 2:
Mailing Address - City:PALERMO
Mailing Address - State:CA
Mailing Address - Zip Code:95968-9720
Mailing Address - Country:US
Mailing Address - Phone:706-396-2746
Mailing Address - Fax:
Practice Address - Street 1:2430 BIRD ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4908
Practice Address - Country:US
Practice Address - Phone:530-538-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$Medicaid