Healthcare Provider Details

I. General information

NPI: 1578915831
Provider Name (Legal Business Name): DR. CHI HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BRYANT ST # 711
PALO ALTO CA
94301-1704
US

IV. Provider business mailing address

555 BRYANT ST # 711
PALO ALTO CA
94301-1704
US

V. Phone/Fax

Practice location:
  • Phone: 650-691-8978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY28402
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: