Provider Demographics
NPI:1124200811
Name:HOM, CHRISTY LING (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:LING
Last Name:HOM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:LING
Other - Last Name:CHIANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 THE CITY DR S
Mailing Address - Street 2:ROUTE 88
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3201
Mailing Address - Country:US
Mailing Address - Phone:714-456-2927
Mailing Address - Fax:174-456-5112
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:ROUTE 88
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-2927
Practice Address - Fax:174-456-5112
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19889103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent