Provider Demographics
NPI:1598195380
Name:CHANG, ALLEN PATRICK (MSW, MBA)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:PATRICK
Last Name:CHANG
Suffix:
Gender:M
Credentials:MSW, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 S JOHNSON CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-7828
Mailing Address - Country:US
Mailing Address - Phone:949-500-8227
Mailing Address - Fax:
Practice Address - Street 1:3535 S JOHNSON CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7828
Practice Address - Country:US
Practice Address - Phone:949-500-8227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical