Healthcare Provider Details

I. General information

NPI: 1033542394
Provider Name (Legal Business Name): MS. YUE HUA XU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICKIE XU

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S COMMONWEALTH AVE 600
LOS ANGELES CA
90005-4001
US

IV. Provider business mailing address

1359 N GRAND AVE.
COVINA CA
91724
US

V. Phone/Fax

Practice location:
  • Phone: 213-739-5437
  • Fax: 213-252-0287
Mailing address:
  • Phone: 626-430-2938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: