Healthcare Provider Details

I. General information

NPI: 1669707972
Provider Name (Legal Business Name): BETTY TSANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 12/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11429 VALLEY BLVD
EL MONTE CA
91731-3229
US

IV. Provider business mailing address

11429 VALLEY BLVD
EL MONTE CA
91731-3229
US

V. Phone/Fax

Practice location:
  • Phone: 626-442-8391
  • Fax:
Mailing address:
  • Phone: 626-442-8391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF95820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: