Healthcare Provider Details

I. General information

NPI: 1881458974
Provider Name (Legal Business Name): SUSAN CHI PSYCHOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD STE 403
PASADENA CA
91101-2018
US

IV. Provider business mailing address

595 E COLORADO BLVD STE 403
PASADENA CA
91101-2018
US

V. Phone/Fax

Practice location:
  • Phone: 626-775-7121
  • Fax:
Mailing address:
  • Phone: 626-775-7121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN Y CHI
Title or Position: CEO/LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 626-775-7121