Provider Demographics
NPI:1154367357
Name:CHANG, EMMY SHINJU (LMFT)
Entity type:Individual
Prefix:MRS
First Name:EMMY
Middle Name:SHINJU
Last Name:CHANG
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:SHINJU
Other - Middle Name:EMMY
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:139B ALICE ST
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3926
Mailing Address - Country:US
Mailing Address - Phone:626-236-2887
Mailing Address - Fax:626-631-2736
Practice Address - Street 1:650 W DUARTE RD STE 206
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7643
Practice Address - Country:US
Practice Address - Phone:626-236-2887
Practice Address - Fax:626-445-6818
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38998106H00000X
CAMFC 38998106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist