Provider Demographics
NPI:1356959712
Name:CHOI, JOANNE (PSYD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:CHOI
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 PIER AVE STE B #316
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254
Mailing Address - Country:US
Mailing Address - Phone:310-554-8944
Mailing Address - Fax:
Practice Address - Street 1:2512 ARTESIA BLVD STE 260B
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-5366
Practice Address - Country:US
Practice Address - Phone:310-554-8944
Practice Address - Fax:310-554-8954
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-20-40642103K00000X
CA35600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst