Healthcare Provider Details

I. General information

NPI: 1962077990
Provider Name (Legal Business Name): ROLAND HSU LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/21/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 BIRCH ST.
PALO ALTO CA
94306-1103
US

IV. Provider business mailing address

3266 RAMONA ST
PALO ALTO CA
94306-2944
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 650-269-4976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100838
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: