Healthcare Provider Details

I. General information

NPI: 1376457143
Provider Name (Legal Business Name): JUE AMY WANG AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 CAMPISI WAY STE 1D
CAMPBELL CA
95008-2351
US

IV. Provider business mailing address

1166 POMEGRANATE CT
SUNNYVALE CA
94087-2311
US

V. Phone/Fax

Practice location:
  • Phone: 408-462-0794
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: