Provider Demographics
NPI:1962625517
Name:XIONG, CHOU CHUCK
Entity type:Individual
Prefix:
First Name:CHOU
Middle Name:CHUCK
Last Name:XIONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHUCK
Other - Middle Name:
Other - Last Name:XIONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7171 BOWLING DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAC
Mailing Address - State:CA
Mailing Address - Zip Code:95838
Mailing Address - Country:US
Mailing Address - Phone:191-638-5869
Mailing Address - Fax:
Practice Address - Street 1:7171 BOWLING DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2034
Practice Address - Country:US
Practice Address - Phone:191-638-5869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225400000X, 225400000X
175T00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No175T00000XOther Service ProvidersPeer Specialist