Chacon, Sandra Marie

Chacon, Sandra Marie is an sole proprietor health care provider with primary practice located at 1359 N Grand Ave , Covina CA 91724-1016. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner is her primary health care specialty. Chacon, Sandra Marie can be contacted via phone (626) 430-2900.

Contact Information

Primary practice address
1359 N Grand Ave Covina CA 91724-1016
Phone: (626) 430-2900
Fax: (626) 331-0035
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X

Profile Details

NPI number 1609126218
LBN Legal business name Chacon, Sandra Marie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 12th, 2012
Last updated Mar 11th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609126218 NPPES
California Other 95-3893470 MEDI-CAL

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