Provider Demographics
NPI:1174769632
Name:CHAMBERS, CHELSEA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:HAPPY CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:96039-1016
Mailing Address - Country:US
Mailing Address - Phone:530-493-5257
Mailing Address - Fax:530-493-5270
Practice Address - Street 1:64236 SECOND AVENUE
Practice Address - Street 2:
Practice Address - City:HAPPY CAMP
Practice Address - State:CA
Practice Address - Zip Code:96039-1016
Practice Address - Country:US
Practice Address - Phone:530-493-5257
Practice Address - Fax:530-493-5270
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21783363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant