Provider Demographics
NPI:1023236189
Name:XIONG, SEAN CHOUR
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:CHOUR
Last Name:XIONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7357 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6119
Mailing Address - Country:US
Mailing Address - Phone:858-571-8724
Mailing Address - Fax:
Practice Address - Street 1:2359 ULRIC ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6402
Practice Address - Country:US
Practice Address - Phone:858-268-4933
Practice Address - Fax:858-268-0244
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health