Active NPI
Juanita B. Chin, PH.D., LCSW
- Psychologist
- Los Angeles, CA
National Provider Identifier
1639298698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY16086
- Practice address
- 439 W 97TH St
Los Angeles, CA 90003-3968 - Phone
- (323) 754-2856
- Fax
- (323) 754-1843
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY16086 | CA | Primary |
| Clinical Social Worker | 1041C0700X | LCS5372 | CA |
Addresses
Primary practice location
439 W 97TH St
Los Angeles, CA 90003-3968
Mailing address
8120 Chase Ave
Los Angeles, CA 90045-2708
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16086 | CA | MD | Psychologist |
| LCS5372 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222992000000",
"number": "1639298698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8120 CHASE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900452708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "439 W 97TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900033968",
"telephone_number": "323-754-2856",
"fax_number": "323-754-1843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN",
"first_name": "JUANITA",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "PH.D., LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2008-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY16086",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS5372",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.