Healthcare Provider Details

I. General information

NPI: 1194271643
Provider Name (Legal Business Name): SABRINA HSU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 REDONDO AVE FL 3
LONG BEACH CA
90806-2325
US

IV. Provider business mailing address

26661 MATIAS DR
MISSION VIEJO CA
92691-4906
US

V. Phone/Fax

Practice location:
  • Phone: 562-256-2900
  • Fax:
Mailing address:
  • Phone: 949-716-9686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number108176
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW108176
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number84701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: