Healthcare Provider Details

I. General information

NPI: 1578680021
Provider Name (Legal Business Name): CHING CHRISTINE LAU REGISTR PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S LA FAYETTE PARK PL FL 3
LOS ANGELES CA
90057-1607
US

IV. Provider business mailing address

520 SO. LAFAYETTE PARK PLACE 3RD FLOOR
LA CA
90057
US

V. Phone/Fax

Practice location:
  • Phone: 213-252-2100
  • Fax: 213-383-3146
Mailing address:
  • Phone: 213-252-2100
  • Fax: 213-383-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberRPS-2007008
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: