Provider Demographics
NPI:1780257048
Name:CHAPMAN, TABITHA (AMFT)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52997 CARROUSEL CT
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-7511
Mailing Address - Country:US
Mailing Address - Phone:951-293-7470
Mailing Address - Fax:
Practice Address - Street 1:28991 OLD TOWN FRONT ST STE 201
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5804
Practice Address - Country:US
Practice Address - Phone:951-293-7470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TF0200X
CA143392106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic