Provider Demographics
NPI:1780403618
Name:CHIMARIOS, AFRODITE (AMFT)
Entity type:Individual
Prefix:
First Name:AFRODITE
Middle Name:
Last Name:CHIMARIOS
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 1:1616 DELTA ST APT 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-2663
Mailing Address - Country:US
Mailing Address - Phone:323-541-7261
Mailing Address - Fax:
Practice Address - Street 1:5723 MELROSE AVE STE 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-3889
Practice Address - Country:US
Practice Address - Phone:323-541-7261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138897103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical