Healthcare Provider Details

I. General information

NPI: 1861213928
Provider Name (Legal Business Name): YUTING ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10519 MARSEN ST
EL MONTE CA
91731-1545
US

IV. Provider business mailing address

701 E FOOTHILL BLVD UNIT 1086
AZUSA CA
91702-2606
US

V. Phone/Fax

Practice location:
  • Phone: 510-364-4968
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: