Provider Demographics
NPI:1669602637
Name:CHATMAN, CHAUNCEY PETER LAMAR (MA, MFT)
Entity type:Individual
Prefix:
First Name:CHAUNCEY
Middle Name:PETER LAMAR
Last Name:CHATMAN
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:CHATMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, MFT
Mailing Address - Street 1:2415 UNIVERSITY AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-1148
Mailing Address - Country:US
Mailing Address - Phone:650-363-4030
Mailing Address - Fax:650-631-1101
Practice Address - Street 1:2415 UNIVERSITY AVE STE 301
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1148
Practice Address - Country:US
Practice Address - Phone:650-363-4030
Practice Address - Fax:650-328-6834
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45560106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist