Provider Demographics
NPI:1518581255
Name:CHAMBERS, ELEANOR
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
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 276950
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-6950
Mailing Address - Country:US
Mailing Address - Phone:415-600-5959
Mailing Address - Fax:415-369-1392
Practice Address - Street 1:601 DUBOCE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3389
Practice Address - Country:US
Practice Address - Phone:415-600-5959
Practice Address - Fax:415-369-1392
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY35254103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical