Provider Demographics
NPI:1588919377
Name:TSOI, HOLLIS CHEONG (PSYD)
Entity type:Individual
Prefix:DR
First Name:HOLLIS
Middle Name:CHEONG
Last Name:TSOI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 S GLADYS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3922
Mailing Address - Country:US
Mailing Address - Phone:626-272-4967
Mailing Address - Fax:
Practice Address - Street 1:5838 EDISON PL STE 100
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-5520
Practice Address - Country:US
Practice Address - Phone:626-272-4967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30778103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical