Provider Demographics
NPI:1063610004
Name:ANGENY-SHOWALTER, CHASSITY (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHASSITY
Middle Name:
Last Name:ANGENY-SHOWALTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 S LEMON AVE #4028
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789
Mailing Address - Country:US
Mailing Address - Phone:916-546-5228
Mailing Address - Fax:866-491-6341
Practice Address - Street 1:340 S LEMON AVE #4028
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789
Practice Address - Country:US
Practice Address - Phone:916-546-5228
Practice Address - Fax:866-491-6341
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23036103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist