=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720326267
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KORINA RACHEL JOCHIM LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2013
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2705 E BURNSIDE ST STE 206
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97214-1768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-636-1552
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1390 RANDALL DR
-----------------------------------------------------
City | CAMBRIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93428-5743
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-636-1552
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 51313
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | T1468
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------