Basic Information
| Provider Information | |||||||||
| NPI: | 1114427333 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REID | ||||||||
| FirstName: | CHELSEA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 921 W AVENUE J STE C | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935343443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6619490131 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20501 VENTURA BLVD | ||||||||
| Address2: | |||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913642337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8186570411 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2018 | ||||||||
| LastUpdateDate: | 03/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | AMFT104295 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.