Provider Demographics
NPI:1386622074
Name:CHATIGNY, ANITA JO (PHD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:JO
Last Name:CHATIGNY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANITA
Other - Middle Name:LARA
Other - Last Name:CHATIGNY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2225 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7022
Mailing Address - Country:US
Mailing Address - Phone:760-416-8589
Mailing Address - Fax:760-416-2061
Practice Address - Street 1:2225 E TAHQUITZ CANYON WAY
Practice Address - Street 2:SUITE 5
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7022
Practice Address - Country:US
Practice Address - Phone:760-416-8589
Practice Address - Fax:760-416-2061
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10058103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL100580Medicare UPIN