Dr. Randall Lee Ahn
Clinical Child & Adolescent Psychologist
1201 Lincoln St Suite 201
Columbia
, South Carolina 29201
Dr. Randall Lee Ahn
Clinical Child & Adolescent Psychologist
1201 Lincoln St Suite 201
Columbia
, South Carolina 29201
(949) 414-7149
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Randall Lee Ahn
- 241 E 17th St # 1029
- Costa Mesa, CA
- Zip : 92627-3831
- Phone : (949) 414-7149
Second Address
- Dr. Randall Lee Ahn
- 1201 Lincoln St Suite 201
- Columbia, SC
- Zip : 29201
- Phone : (949) 414-7149
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY13956 | CA |
National Provider Identifier
| NPI | 1093939399 |
|---|---|
| Provider Name | Dr. Randall Lee Ahn |
| First Address | Costa Mesa, CA 92627-3831 |
| Second Address | Columbia, SC 29201 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/04/2007 |
| Last Update Date | 14/02/2022 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| PSY13956 | PSYCHOLOGY LICENSE (01) | CA |
| PSY-TL-0636 | PSYCHOLOGY LICENSE (01) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.