Healthcare Provider Details

I. General information

NPI: 1619894078
Provider Name (Legal Business Name): DIANA WU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1710 HAMILTON AVE
SAN JOSE CA
95125-5424
US

IV. Provider business mailing address

1094 ERIN WAY
CAMPBELL CA
95008-6128
US

V. Phone/Fax

Practice location:
  • Phone: 408-499-2313
  • Fax:
Mailing address:
  • Phone: 408-499-2313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: