Healthcare Provider Details

I. General information

NPI: 1659842276
Provider Name (Legal Business Name): XIAOCHANG HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 UNIVERSITY AVE STE 191
BERKELEY CA
94704-1000
US

IV. Provider business mailing address

1122 40TH ST APT 303
EMERYVILLE CA
94608-3797
US

V. Phone/Fax

Practice location:
  • Phone: 508-659-2299
  • Fax:
Mailing address:
  • Phone: 650-283-5244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: