Provider Demographics
NPI:1457039182
Name:CHAVEZ, JOSELYN MICHELLE (AMFT 135461)
Entity type:Individual
Prefix:
First Name:JOSELYN
Middle Name:MICHELLE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:AMFT 135461
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 SANTA BARBARA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2232
Mailing Address - Country:US
Mailing Address - Phone:805-637-2705
Mailing Address - Fax:
Practice Address - Street 1:220 S VOLUNTARIO ST APT B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3437
Practice Address - Country:US
Practice Address - Phone:805-637-2705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135461106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist