Healthcare Provider Details

I. General information

NPI: 1174329544
Provider Name (Legal Business Name): TERRI HUH, PSYCHOLOGIST, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 BONITA AVE # 208
BERKELEY CA
94704-1014
US

IV. Provider business mailing address

1918 BONITA AVE # 208
BERKELEY CA
94704-1014
US

V. Phone/Fax

Practice location:
  • Phone: 415-806-1014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERRI HUH
Title or Position: DIRECTOR
Credential: PHD
Phone: 415-806-1014