Healthcare Provider Details

I. General information

NPI: 1457727166
Provider Name (Legal Business Name): XIUQI HUANG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SO. LAFAYETTE PARK PLACE
LA CA
90057-5400
US

IV. Provider business mailing address

520 SO. LAFAYETTE PARK PLACE
LA CA
90057-5400
US

V. Phone/Fax

Practice location:
  • Phone: 213-252-2100
  • Fax: 213-383-3146
Mailing address:
  • Phone: 213-252-2100
  • Fax: 213-383-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number93702
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW73463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: