Provider Demographics
NPI:1831668441
Name:CHOUCHENA, FRAN AGNES
Entity Type:Individual
Prefix:
First Name:FRAN
Middle Name:AGNES
Last Name:CHOUCHENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-3519
Mailing Address - Country:US
Mailing Address - Phone:650-746-2701
Mailing Address - Fax:
Practice Address - Street 1:700 STEWART AVE
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-3519
Practice Address - Country:US
Practice Address - Phone:650-746-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool