Healthcare Provider Details

I. General information

NPI: 1144408402
Provider Name (Legal Business Name): ANNIE C SHUI MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 LAGUNA HONDA BLVD C4
SAN FRANCISCO CA
94116-1411
US

IV. Provider business mailing address

375 LAGUNA HONDA BLVD C4
SAN FRANCISCO CA
94116-1411
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-2168
  • Fax: 415-759-2177
Mailing address:
  • Phone: 415-759-2168
  • Fax: 415-759-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number56041
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number51408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: