Provider Demographics
NPI:1184838161
Name:CHINN, GEORGE II (RAS)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:CHINN
Suffix:II
Gender:M
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 WILLOW PASS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2588
Mailing Address - Country:US
Mailing Address - Phone:925-363-5000
Mailing Address - Fax:925-363-5075
Practice Address - Street 1:3024 WILLOW PASS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2588
Practice Address - Country:US
Practice Address - Phone:925-363-5000
Practice Address - Fax:925-363-5075
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0501030812101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)