Provider Demographics
NPI:1528258027
Name:FONG, FRANCIS CHIKEUNG (LCSW)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:CHIKEUNG
Last Name:FONG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:CHI-KEUNG
Other - Middle Name:
Other - Last Name:FONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:777 E SANTA CLARA ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-1934
Mailing Address - Country:US
Mailing Address - Phone:408-977-4593
Mailing Address - Fax:
Practice Address - Street 1:777 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-1934
Practice Address - Country:US
Practice Address - Phone:408-977-4593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS275841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical