Provider Demographics
NPI:1487032637
Name:CHANG, CHIA NING (MFT INTERN)
Entity Type:Individual
Prefix:MRS
First Name:CHIA NING
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 CASTRO ST STE B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3682
Mailing Address - Country:US
Mailing Address - Phone:650-867-5952
Mailing Address - Fax:
Practice Address - Street 1:1304 CASTRO ST STE B
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3682
Practice Address - Country:US
Practice Address - Phone:650-867-5952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79696106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist