Provider Demographics
NPI:1215495981
Name:CHASE, ANNA ISABEL
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ISABEL
Last Name:CHASE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-1425
Mailing Address - Country:US
Mailing Address - Phone:805-332-1349
Mailing Address - Fax:
Practice Address - Street 1:245 INGER DR STE 103B
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-8669
Practice Address - Country:US
Practice Address - Phone:805-346-8185
Practice Address - Fax:805-346-8185
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-12
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program