Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY23582 | CA |
Y | 103G00000X | Clinical Psychologist | PSY23582 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY23582 | CA |
NPI | 1629477872 |
---|---|
Provider Name | Dr. Joy Chudzynski |
First Address | Los Angeles, CA 90035-3802 |
Second Address | Los Angeles, CA 90048-5426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2014 |
Last Update Date | 13/08/2014 |