Jacklyn Lee Chandler, PH.D.
Individual provider Active NPI Psychologist · Alamo, CA
NPI 1770733503 · NPPES record last updated Sep 29, 2008
Key facts
- NPI
- 1770733503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PSB 32545 (CA)
- Practice address
- 218 Sydney Dr
Alamo, CA 94507-2673 - Phone
- (707) 477-5544
- Fax
- (925) 944-0151
- NPI assigned
- Sep 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSB 32545 | CA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSB 32545 | CA | Yes |
Addresses
Primary practice location
218 Sydney Dr
Alamo, CA 94507-2673
Mailing address
218 Sydney Dr
Alamo, CA 94507-2673
Phone (707) 477-5544
Other providers in Alamo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.