Eloisa Chavez

Individual provider Active NPI Case Manager/Care Coordinator · La Puente, CA

NPI 1124142732 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124142732
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
NONE100 (CA)
Practice address
160 S 7TH Ave
La Puente, CA 91746-3211
Phone
(626) 961-8971
Fax
(626) 961-6685
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
NONE100CAMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NONE100 CA Yes

Addresses

Primary practice location

160 S 7TH Ave
La Puente, CA 91746-3211

Mailing address

160 S 7TH Ave
La Puente, CA 91746-3211
Phone (626) 961-8971

Other providers in La Puente, CA

All providers in La Puente, CA · Case Manager/Care Coordinator in California

Sources for this page

Verify at the official NPI Registry.