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General NPI Number Information
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NPI Number | 1265338172
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Entity Type | Individual
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Provider Name | KEONI JEFFREY CHOCK RN
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Gender | Male
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Dates
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Enumeration Date | 10/16/2026
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Last Update Date | 10/16/2026
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Provider Practice Location Address
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Address Line | 2600 REDONDO AVE FL 5
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City | LONG BEACH
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State | CA
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Zip | 90806-2325
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Country | US
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Telephone | 844-562-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 9672 DAYBREAK DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-7527
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Country | US
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Telephone | 909-222-2897
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 95448945
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License Number State | CA
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