Basic Information
| Provider Information | |||||||||
| NPI: | 1437463304 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAVEZ | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21081 S WESTERN AVE | ||||||||
| Address2: | SUITE 295 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905011703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105336609 | ||||||||
| FaxNumber: | 3107879035 | ||||||||
| Practice Location | |||||||||
| Address1: | 21081 S WESTERN AVE | ||||||||
| Address2: | SUITE 295 | ||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905011703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105336609 | ||||||||
| FaxNumber: | 3107879035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2010 | ||||||||
| LastUpdateDate: | 02/17/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 27929 | CA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.