Healthcare Provider Details

I. General information

NPI: 1780431882
Provider Name (Legal Business Name): XUEJIA CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9353 VALLEY BLVD
ROSEMEAD CA
91770-1923
US

IV. Provider business mailing address

PO BOX 153
SIERRA MADRE CA
91025-0153
US

V. Phone/Fax

Practice location:
  • Phone: 626-753-8630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT153058
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: