Provider Demographics
NPI:1760507602
Name:SISWANTO CHOE, NADIA (LMFT)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:SISWANTO CHOE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:
Other - Last Name:SISWANTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:5550 TOPANGA CANYON BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7448
Mailing Address - Country:US
Mailing Address - Phone:818-631-9608
Mailing Address - Fax:818-631-9608
Practice Address - Street 1:5550 TOPANGA CANYON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7448
Practice Address - Country:US
Practice Address - Phone:818-631-9608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC50343106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist