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General NPI Number Information
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NPI Number | 1912339524
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Entity Type | Individual
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Provider Name | CHRIS LE MA, LPC
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Gender | Male
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 1128 J ST
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City | DAVIS
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State | CA
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Zip | 95616-2130
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Country | US
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Telephone | 530-601-9587
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Fax |
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Provider Business Mailing Address
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Address Line | 1128 J ST
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City | DAVIS
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State | CA
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Zip | 95616-2130
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 428
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 428
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License Number State | CA
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