Healthcare Provider Details

I. General information

NPI: 1134097488
Provider Name (Legal Business Name): LYDIA HUTCHISON LE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SHOWERS DR # D006
MOUNTAIN VIEW CA
94040-1431
US

IV. Provider business mailing address

799 CASTRO ST
MOUNTAIN VIEW CA
94041-2013
US

V. Phone/Fax

Practice location:
  • Phone: 408-771-3129
  • Fax:
Mailing address:
  • Phone: 408-771-3129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number10060
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: