Healthcare Provider Details

I. General information

NPI: 1306653878
Provider Name (Legal Business Name): YURI CHOI MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 E DEERE AVE STE 240
SANTA ANA CA
92705-5716
US

IV. Provider business mailing address

619 MAIN ST
HUNTINGTON BEACH CA
92648-4618
US

V. Phone/Fax

Practice location:
  • Phone: 714-543-4333
  • Fax: 714-543-4398
Mailing address:
  • Phone: 714-402-5475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT148417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: