Healthcare Provider Details

I. General information

NPI: 1467345132
Provider Name (Legal Business Name): PRISCILLA HU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 E JULIAN ST
SAN JOSE CA
95112-4007
US

IV. Provider business mailing address

3766 WILLIAMS RD
SAN JOSE CA
95117-2736
US

V. Phone/Fax

Practice location:
  • Phone: 408-457-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number111945
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: