Provider Demographics
NPI:1902469125
Name:CHOW, JEAN GIN-YI (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:GIN-YI
Last Name:CHOW
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20412 TUFTS CIR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2400
Mailing Address - Country:US
Mailing Address - Phone:909-721-0913
Mailing Address - Fax:
Practice Address - Street 1:20412 TUFTS CIR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-2400
Practice Address - Country:US
Practice Address - Phone:909-721-0913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112589106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist