Healthcare Provider Details

I. General information

NPI: 1487220257
Provider Name (Legal Business Name): MS. HUI CHANG HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20294 FOREST AVE # 1
CASTRO VALLEY CA
94546-4523
US

IV. Provider business mailing address

20294 FOREST AVE # 1
CASTRO VALLEY CA
94546-4523
US

V. Phone/Fax

Practice location:
  • Phone: 415-205-1679
  • Fax:
Mailing address:
  • Phone: 415-205-1679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number57992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: