Healthcare Provider Details

I. General information

NPI: 1962366732
Provider Name (Legal Business Name): GRACE HWANG
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ELM DR
BEVERLY HILLS CA
90212-4011
US

IV. Provider business mailing address

1408 S VAN NESS AVE
LOS ANGELES CA
90019-4603
US

V. Phone/Fax

Practice location:
  • Phone: 310-229-3665
  • Fax:
Mailing address:
  • Phone: 310-229-3665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: