Provider Demographics
NPI:1093217366
Name:PRESCOTT, CHELLSEA A
Entity type:Individual
Prefix:
First Name:CHELLSEA
Middle Name:A
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 BLANCO CIR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4401
Mailing Address - Country:US
Mailing Address - Phone:831-424-6655
Mailing Address - Fax:831-424-9717
Practice Address - Street 1:913 BLANCO CIR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4401
Practice Address - Country:US
Practice Address - Phone:831-424-6655
Practice Address - Fax:831-424-9717
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1320690818101YA0400X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR1320690818OtherREGISTERED ADDICTIONS SPECIALIST