Provider Demographics
NPI:1295134195
Name:CHU, KAI SHIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:KAI SHIN
Middle Name:
Last Name:CHU
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JOSEPHINE
Other - Middle Name:
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:9200 NW 39TH AVE
Mailing Address - Street 2:STE 130 - 3107
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:813-347-9681
Mailing Address - Fax:
Practice Address - Street 1:9200 NW 39TH AVE
Practice Address - Street 2:STE 130 - 3107
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606
Practice Address - Country:US
Practice Address - Phone:813-347-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 390200000X
FLPY10105103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program