Provider Demographics
NPI:1558073072
Name:CK FAMILY THERAPY AND COUNSELING SERVICES
Entity Type:Organization
Organization Name:CK FAMILY THERAPY AND COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:949-885-6884
Mailing Address - Street 1:14742 NEWPORT AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14742 NEWPORT AVE STE 209
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6177
Practice Address - Country:US
Practice Address - Phone:949-885-6884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center