Healthcare Provider Details

I. General information

NPI: 1356959712
Provider Name (Legal Business Name): JOANNE CHOI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 ARTESIA BLVD STE 260B
REDONDO BEACH CA
90278-5366
US

IV. Provider business mailing address

703 PIER AVE STE B #316
HERMOSA BEACH CA
90254
US

V. Phone/Fax

Practice location:
  • Phone: 310-554-8944
  • Fax: 310-554-8954
Mailing address:
  • Phone: 310-554-8944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35600
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-40642
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: