Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 88383 | CA |
N | 225C00000X | Rehabilitation Counselor | 88383 | CA |
NPI | 1265953996 |
---|---|
Provider Name | Thonyoon Chao |
First Address | Ukiah, CA 95482-2077 |
Second Address | Lakeport, CA 95453-5017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2017 |
Last Update Date | 03/06/2019 |