Healthcare Provider Details

I. General information

NPI: 1548934417
Provider Name (Legal Business Name): JUDY HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2329 SANTA CLARA AVE # 202
ALAMEDA CA
94501-4521
US

IV. Provider business mailing address

2329 SANTA CLARA AVE # 202
ALAMEDA CA
94501-4521
US

V. Phone/Fax

Practice location:
  • Phone: 510-519-9909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: