Provider Demographics
NPI:1720896269
Name:CHANDRA CHAIKIN, MS, LICENSED MARRIAGE FAMILY THERAPIST, APC
Entity type:Organization
Organization Name:CHANDRA CHAIKIN, MS, LICENSED MARRIAGE FAMILY THERAPIST, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MFT, BC-DMT, CEDS
Authorized Official - Phone:949-215-0612
Mailing Address - Street 1:25401 CABOT RD STE 115
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25401 CABOT RD STE 115
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5530
Practice Address - Country:US
Practice Address - Phone:949-215-0612
Practice Address - Fax:949-215-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Multi-Specialty