Provider Demographics
NPI:1174689095
Name:CHUN, CURTIS STANLEY (PSYD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:STANLEY
Last Name:CHUN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:CURTIS
Other - Middle Name:
Other - Last Name:CHUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSY 16562
Mailing Address - Street 1:6600 BRUCEVILLE RD
Mailing Address - Street 2:KAISER PERMANENTE PSYCHIATRY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823
Mailing Address - Country:US
Mailing Address - Phone:916-525-6132
Mailing Address - Fax:916-525-6188
Practice Address - Street 1:6600 BRUCEVILLE RD
Practice Address - Street 2:KAISER PERMANENTE PSYCHIATRY
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823
Practice Address - Country:US
Practice Address - Phone:916-525-6132
Practice Address - Fax:916-525-6188
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16562103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical