Healthcare Provider Details

I. General information

NPI: 1356550628
Provider Name (Legal Business Name): YU-JU HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W STEWART DR STE 404
ORANGE CA
92868-3855
US

IV. Provider business mailing address

42 LATITUDE
IRVINE CA
92618-8821
US

V. Phone/Fax

Practice location:
  • Phone: 714-707-6466
  • Fax:
Mailing address:
  • Phone: 949-302-4931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number7637
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: