Healthcare Provider Details

I. General information

NPI: 1992421879
Provider Name (Legal Business Name): CRISTINA MINH HOANG CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39675 CEDAR BLVD STE 155
NEWARK CA
94560-5490
US

IV. Provider business mailing address

39655 TRINITY WAY APT 8207
FREMONT CA
94538-2038
US

V. Phone/Fax

Practice location:
  • Phone: 877-510-0685
  • Fax:
Mailing address:
  • Phone: 949-232-8356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number31428
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: