Provider Demographics
NPI:1013177187
Name:CHOI, KEVIN WING KEUNG (PSYD)
Entity type:Individual
Prefix:DR
First Name:KEVIN WING KEUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KEVIN
Other - Middle Name:WING KEUNG
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:280 S. LEMON AVE #2002
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91788
Mailing Address - Country:US
Mailing Address - Phone:415-269-3057
Mailing Address - Fax:
Practice Address - Street 1:3609 SACRAMENTO STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-354-5646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31664103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical