Provider Demographics
NPI:1487895736
Name:CHIDEKEL, ADAM (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:CHIDEKEL
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28494 WESTINGHOUSE PL STE 314
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-0936
Mailing Address - Country:US
Mailing Address - Phone:818-259-4046
Mailing Address - Fax:
Practice Address - Street 1:28494 WESTINGHOUSE PL STE 314
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0936
Practice Address - Country:US
Practice Address - Phone:818-259-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13156103TC0700X
CAPSY 13156103TF0200X, 103TH0004X
CAPSY13156103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth