Provider Demographics
NPI:1306551106
Name:KUNAPULI, CHELSEA MARIE (AMFT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:KUNAPULI
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:MARIE
Other - Last Name:BALCEZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:7084 BERGAMOT AVE
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-5064
Mailing Address - Country:US
Mailing Address - Phone:805-917-6860
Mailing Address - Fax:805-917-6861
Practice Address - Street 1:7084 BERGAMOT AVE
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-5064
Practice Address - Country:US
Practice Address - Phone:805-917-6860
Practice Address - Fax:805-917-6861
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122465101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health