Individual provider Active NPI

Koyun CHI, PHD

  • Clinical Psychologist
  • Scottsdale, AZ
National Provider Identifier
1063845360
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY5332 Issued in AZ
Practice address
7373 N Scottsdale Rd Ste C190
Scottsdale, AZ 85253-3754
Phone
(480) 448-6571
Fax
(480) 771-5858
NPI assigned
Aug 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PSY5332 AZ Primary

Addresses

Primary practice location

7373 N Scottsdale Rd Ste C190
Scottsdale, AZ 85253-3754

Mailing address

7144 S 7TH LN
Phoenix, AZ 85041-6765
Phone (650) 274-1905

Other practice location 1

3626 Balboa St
San Francisco, CA 94121-2604
Phone (415) 668-5955

Other names 1

  • Alice CHI Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY5332AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Choulet Performance Scottsdale LLC CurrentSince Dec 12, 2021 Accepting new patients

Locations

7702 E Doubletree Ranch Rd
Ste 300
Scottsdale, AZ 85258
Phone (480) 296-5429

7373 N Scottsdale Rd
Ste C190
Scottsdale, AZ 85253
Phone (480) 370-5656

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1063845360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7144 S 7TH LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416765",
            "telephone_number": "650-274-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 N SCOTTSDALE RD STE C190",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852533754",
            "telephone_number": "480-448-6571",
            "fax_number": "480-771-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3626 Balboa St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941212604",
            "country_code": "US",
            "telephone_number": "415-668-5955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHI",
        "first_name": "KOYUN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-10",
        "last_updated": "2021-12-06",
        "certification_date": "2021-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "PSY5332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICE",
            "last_name": "CHI",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.