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Khoeun Chhan Baeza

Counselor, Mental Health in Clovis, CA. Individual provider (NPI-1).

NPI number1487310496
StatusActive
Last updated in NPPESNov 14, 2021

Details

NPI
1487310496
Entity type
Individual (NPI-1)
Name
Khoeun Chhan Baeza
Sex
Female
Sole proprietor
No
Enumeration date
Nov 14, 2021
Certification date
Nov 14, 2021
Last updated
Nov 14, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthLMFT111805CAYes

Other names

  • Khoeun Sok Chhan (Former Name)

Practice location

3802 Duncan Ave
Clovis, CA 93619-5174

Phone 559-917-0740

Mailing address

3802 Duncan Ave
Clovis, CA 93619-5174

Phone 559-917-0740

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