Healthcare Provider Details

I. General information

NPI: 1881220937
Provider Name (Legal Business Name): JUSTIN HUI INDIVIDUAL AND FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S KRAEMER BLVD STE 230
PLACENTIA CA
92870-6110
US

IV. Provider business mailing address

PO BOX 3615
LAGUNA HILLS CA
92654-3615
US

V. Phone/Fax

Practice location:
  • Phone: 949-295-8707
  • Fax:
Mailing address:
  • Phone: 949-295-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JUSTIN HUI
Title or Position: PRESIDENT
Credential: LMFT
Phone: 949-295-8707