Healthcare Provider Details

I. General information

NPI: 1205789021
Provider Name (Legal Business Name): JENNY MING TU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23903 LOVELL LN
NEVADA CITY CA
95959-8593
US

IV. Provider business mailing address

23903 LOVELL LN
NEVADA CITY CA
95959-8593
US

V. Phone/Fax

Practice location:
  • Phone: 562-667-6333
  • Fax:
Mailing address:
  • Phone: 510-646-1115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: