Individual
THU CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9355 E STOCKTON BLVD STE 100, ELK GROVE, CA 95624-9476
(916) 683-1109
(916) 683-1140
Mailing address
PO BOX 5157, MODESTO, CA 95352-5157
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0167104
CA
Other
Enumeration date
06/30/2017
Last updated
03/04/2019
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