Provider Demographics
NPI:1487087045
Name:SMITH, CHELSEA IRENE (PSYD)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:IRENE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23822 VALENCIA BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5348
Mailing Address - Country:US
Mailing Address - Phone:661-437-3287
Mailing Address - Fax:661-244-3513
Practice Address - Street 1:23822 VALENCIA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5348
Practice Address - Country:US
Practice Address - Phone:661-437-3287
Practice Address - Fax:661-244-3513
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-17
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33828103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical