Healthcare Provider Details

I. General information

NPI: 1972971349
Provider Name (Legal Business Name): MERCY HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 07/19/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 UCLA MEDICAL PLAZA SUITE 2200
LOS ANGELES CA
90095-8346
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-9989
  • Fax: 310-267-1908
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY33990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: