Healthcare Provider Details

I. General information

NPI: 1174229181
Provider Name (Legal Business Name): JU-LU HUANG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 MIDDLEFIELD AVE
FREMONT CA
94539-9453
US

IV. Provider business mailing address

3113 MIDDLEFIELD AVE
FREMONT CA
94539-5069
US

V. Phone/Fax

Practice location:
  • Phone: 650-773-8048
  • Fax:
Mailing address:
  • Phone: 650-773-8048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95024105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: