Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PSY25078 | CA |
NPI | 1184816654 |
---|---|
Provider Name | Khanh Ngan Phan Hoang |
First Address | Woodland Hills, CA 91367-2543 |
Second Address | Tarzana, CA 91356-3253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2007 |
Last Update Date | 03/10/2013 |