Provider Demographics
NPI:1730268491
Name:HENSON, CHELSEA NICOLE (PSYD)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:NICOLE
Last Name:HENSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:NICOLE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3359 REDPORT DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-0924
Mailing Address - Country:US
Mailing Address - Phone:714-915-1325
Mailing Address - Fax:
Practice Address - Street 1:2222 MARTIN
Practice Address - Street 2:#170
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1458
Practice Address - Country:US
Practice Address - Phone:949-474-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst