Provider Demographics
NPI:1669808754
Name:CHAMBERS, JINAKA
Entity type:Individual
Prefix:
First Name:JINAKA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 N OAK GROVE DR
Mailing Address - Street 2:APT. 726
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-3516
Mailing Address - Country:US
Mailing Address - Phone:205-886-0716
Mailing Address - Fax:
Practice Address - Street 1:7901 NE 10TH ST
Practice Address - Street 2:SUITE A-209
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-3600
Practice Address - Country:US
Practice Address - Phone:405-962-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200497040AMedicaid