| Provider / Organization | NPI | Date Certified |
|---|---|---|
| GORDON CHAVEZ | 1720659691 | 2021-07-12 |
Gordon Chavez is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1720659691. Registration indicates Gordon Chavez is a provider of services with a specialization in Nursing Service Providers, Licensed Psychiatric Technician (Licensed Psychiatric Technician, ) (Licensed Psychiatric Technician, Nursing Service Providers)
| Entity Type | Individual |
| Provider Name | Gordon Chavez Jr. |
| Practice Office Address | 1055 W HENDERSON AVE STE 2 PORTERVILLE, CA US |
| Practice Office Telephone | 5597881200 |
| Mailing Address | 1055 W HENDERSON AVE STE 2 PORTERVILLE, CA 932571490 US |
| Code | Practice | License No State |
|---|---|---|
| 167G00000X PRIMARY | Nursing Service Providers Licensed Psychiatric Technician Licensed Psychiatric Technician Licensed Psychiatric Technician Nursing Service Providers | PT34762
CA |