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General NPI Number Information
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NPI Number | 1225292097
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Entity Type | Individual
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Provider Name | ELIZABETH PINGHWA CHANG PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 902 S MYRTLE AVE
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City | MONROVIA
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State | CA
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Zip | 91016-3427
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Country | US
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Telephone | 626-216-5915
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Fax |
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Provider Business Mailing Address
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Address Line | 902 S MYRTLE AVE
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City | MONROVIA
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State | CA
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Zip | 91016-3427
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Country | US
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Telephone | 626-216-5915
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY25501
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License Number State | CA
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