Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY20014 | CA |
N | 103T00000X | Psychologist | PSY20014 | CA |
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | PSY20014 | CA |
N | 103TC0700X | Clinical Psychologist | PSY20014 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1629213897 |
---|---|
Provider Name | Dr. Angela Marie Chanter |
First Address | Roseville, CA 95661-7976 |
Second Address | Roseville, CA 95661-7976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2008 |
Last Update Date | 02/12/2008 |