Provider Demographics
NPI:1720235005
Name:CHIN, LANI MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LANI
Middle Name:MARIE
Last Name:CHIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 POLK STREET
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2810
Mailing Address - Country:US
Mailing Address - Phone:310-344-5550
Mailing Address - Fax:
Practice Address - Street 1:574 POLK STREET
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2810
Practice Address - Country:US
Practice Address - Phone:310-344-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24971103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical