Individual
GRACE CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10653 RIVERSIDE DR, NORTH HOLLYWOOD, CA 91602-2341
(213) 787-7644
Mailing address
3183 WILSHIRE BLVD # 196D5, LOS ANGELES, CA 90010-1211
(213) 787-7644
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31147
CA
225C00000X
Rehabilitation Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/27/2018
Last updated
06/13/2020
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