Provider Demographics
NPI:1104238021
Name:PEPIN, CHELSIE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:CHELSIE
Middle Name:
Last Name:PEPIN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3934 MURPHY CANYON RD STE B202
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4437
Mailing Address - Country:US
Mailing Address - Phone:619-281-6067
Mailing Address - Fax:
Practice Address - Street 1:3934 MURPHY CANYON RD STE B202
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4437
Practice Address - Country:US
Practice Address - Phone:619-281-6067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-15696103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-14-15696OtherBEHAVIOR ANALYST CERTIFICATION BOARD