Healthcare Provider Details

I. General information

NPI: 1336084987
Provider Name (Legal Business Name): VICTORIA CHARLIE CHOI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 3RD AVE NW
AUSTIN MN
55912-2378
US

IV. Provider business mailing address

3501 HARBISON DR UNIT 1902
VACAVILLE CA
95687-3937
US

V. Phone/Fax

Practice location:
  • Phone: 507-460-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number40687
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: