Provider Demographics
NPI:1811277387
Name:CHO, AILEEN B (MA, RDT, LMFT)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:B
Last Name:CHO
Suffix:
Gender:F
Credentials:MA, RDT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25513 NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2923
Mailing Address - Country:US
Mailing Address - Phone:310-347-7275
Mailing Address - Fax:
Practice Address - Street 1:18 CHENERY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-2707
Practice Address - Country:US
Practice Address - Phone:323-379-5299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1649474826Other251S00000X-COMMUNITY/BEHAVIORAL HEALTH