Healthcare Provider Details

I. General information

NPI: 1922849504
Provider Name (Legal Business Name): ZHIDI XU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BENJAMIN XU

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9353 VALLEY BLVD
ROSEMEAD CA
91770-1923
US

IV. Provider business mailing address

1465 65TH ST APT 405
EMERYVILLE CA
94608-1162
US

V. Phone/Fax

Practice location:
  • Phone: 626-287-2988
  • Fax:
Mailing address:
  • Phone: 510-847-8581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: