Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY30252 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY30252 | CA |
NPI | 1003011230 |
---|---|
Provider Name | Emily P. Chen |
First Address | Los Angeles, CA 90034-3740 |
Second Address | Torrance, CA 90505-6141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 30/05/2020 |