Provider Demographics
NPI:1366914582
Name:CHON, LORA
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:CHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17870 NEWHOPE ST STE 104-220
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5439
Mailing Address - Country:US
Mailing Address - Phone:949-407-9913
Mailing Address - Fax:
Practice Address - Street 1:17870 NEWHOPE ST STE 104-220
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5439
Practice Address - Country:US
Practice Address - Phone:949-407-9913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NC2550103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst