Provider Demographics
NPI:1568887263
Name:KHUON, REKHA MENG (LCSW)
Entity Type:Individual
Prefix:
First Name:REKHA
Middle Name:MENG
Last Name:KHUON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REKHA
Other - Middle Name:
Other - Last Name:MENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4510 E PACIFIC COAST HWY STE 600
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-6914
Mailing Address - Country:US
Mailing Address - Phone:562-346-3100
Mailing Address - Fax:
Practice Address - Street 1:4510 E PACIFIC COAST HWY STE 600
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-6914
Practice Address - Country:US
Practice Address - Phone:213-271-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 171M00000X
CALCSW937321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator