Healthcare Provider Details

I. General information

NPI: 1275009615
Provider Name (Legal Business Name): ELIZABETH HUA LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 S EL CAMINO REAL STE 206
OCEANSIDE CA
92054-6281
US

IV. Provider business mailing address

1050 UNIVERSITY AVE # 31
SAN DIEGO CA
92103-3359
US

V. Phone/Fax

Practice location:
  • Phone: 442-245-7097
  • Fax:
Mailing address:
  • Phone: 415-672-9629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: