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Provider Information for 1235781279


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CHLOE JEAN DOBBERT


Sex: Female

NPI: 1235781279
Last Updated: 2023-10-30
Certification Date: 2023-10-30

Details

NameValue
NPI1235781279
Enumeration Date2019-07-10
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 3200 E GUASTI RD STE 100
ONTARIO, CA 91761-8661
United States

Phone: 925-550-1223 | Fax:
 
Primary Practice Address 3200 E GUASTI RD STE 122
ONTARIO, CA 91761-8661
United States

Phone: 925-550-1223 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCA951946482
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 106H00000X - Marriage & Family Therapist CA116212
Yes 106H00000X - Marriage & Family Therapist CA132123