Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | CA |
NPI | 1003094087 |
---|---|
Provider Name | Mr. Thich N. Hong |
First Address | Santa Ana, CA 92704-6223 |
Second Address | Santa Ana, CA 92704-6223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 01/02/2008 |