Healthcare Provider Details

I. General information

NPI: 1821713504
Provider Name (Legal Business Name): PALO ALTO PSYCHOLOGY TECHNOLOGIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 TENNYSON AVE
PALO ALTO CA
94301-3836
US

IV. Provider business mailing address

361 TENNYSON AVE
PALO ALTO CA
94301-3836
US

V. Phone/Fax

Practice location:
  • Phone: 650-384-0384
  • Fax:
Mailing address:
  • Phone: 650-384-0384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALBERT HUA
Title or Position: CEO
Credential: PHD
Phone: 650-384-0384