Healthcare Provider Details

I. General information

NPI: 1114743473
Provider Name (Legal Business Name): MAYA HSU MA, AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3867 HOWE ST
OAKLAND CA
94611-5343
US

IV. Provider business mailing address

1675 7TH ST UNIT 22018
OAKLAND CA
94623-6070
US

V. Phone/Fax

Practice location:
  • Phone: 510-542-9470
  • Fax:
Mailing address:
  • Phone: 650-281-3970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17962
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number150372
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: