Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ASW62160 | CA |
N | 101YM0800X | Mental Health Counselor | LCSW81087 | CA |
Y | 1041C0700X | Clinical Social Worker | LCSW81087 | CA |
NPI | 1003274515 |
---|---|
Provider Name | Ms. Susan Myunghee Choi |
First Address | Fairfield, CA 94534-9600 |
Second Address | Fairfield, CA 94534-9600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2016 |
Last Update Date | 29/01/2018 |