Mayder Chacon, RN

Individual provider Active NPI Case Management Registered Nurse · Arleta, CA

NPI 1194921965 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1194921965
Entity type
Individual (NPI type 1)
Primary specialty
Case Management Registered Nurse 163WC0400X
License
583986 (CA)
Practice address
8902 Woodman Ave
Arleta, CA 91331-6401
Phone
(818) 830-7033
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
583986CAMDCase Management Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
El Proyecto del Barrio, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 583986 CA Yes

Addresses

Primary practice location

8902 Woodman Ave
Arleta, CA 91331-6401

Mailing address

8902 Woodman Ave
Arleta, CA 91331-6401
Phone (818) 830-7033

Other identifiers

IdentifierTypeStateIssuer
EAP70468FOtherCAEAPC PROGRAM

Other providers in Arleta, CA

All providers in Arleta, CA · Case Management Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.