Healthcare Provider Details

I. General information

NPI: 1639739329
Provider Name (Legal Business Name): KASEY CHIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2019
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 MOTOR AVE STE 110
LOS ANGELES CA
90034-3766
US

IV. Provider business mailing address

3424 MOTOR AVE # 101
LOS ANGELES CA
90034-4710
US

V. Phone/Fax

Practice location:
  • Phone: 424-672-6700
  • Fax: 424-672-6819
Mailing address:
  • Phone: 424-672-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: