Basic Information
Provider Information
NPI: 1003141664
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOI
FirstName: STEVEN
MiddleName: JIN
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2100 NAPA VALLEJO HWY
Address2:  
City: NAPA
State: CA
PostalCode: 945586293
CountryCode: US
TelephoneNumber: 7072542712
FaxNumber: 7072535097
Practice Location
Address1: 2100 NAPA VALLEJO HWY
Address2:  
City: NAPA
State: CA
PostalCode: 945586293
CountryCode: US
TelephoneNumber: 7072542712
FaxNumber: 7072535097
Other Information
ProviderEnumerationDate: 10/14/2009
LastUpdateDate: 03/21/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY 22052CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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