Provider Demographics
NPI:1508381443
Name:PARK, CHEN ZHANG
Entity Type:Individual
Prefix:
First Name:CHEN
Middle Name:ZHANG
Last Name:PARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1220 HIGHLAND AVE # 1934
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2512
Mailing Address - Country:US
Mailing Address - Phone:626-524-5402
Mailing Address - Fax:
Practice Address - Street 1:1909 HUNTINGTON DR UNIT C
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2657
Practice Address - Country:US
Practice Address - Phone:626-524-5402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health