Healthcare Provider Details

I. General information

NPI: 1326741034
Provider Name (Legal Business Name): YONGSIL CHOI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 VICTORIA ST
COSTA MESA CA
92627-7131
US

IV. Provider business mailing address

166 FULL MOON
IRVINE CA
92618-8806
US

V. Phone/Fax

Practice location:
  • Phone: 949-642-2734
  • Fax:
Mailing address:
  • Phone: 949-922-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95322053
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95038185
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95322053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: