Healthcare Provider Details

I. General information

NPI: 1124356837
Provider Name (Legal Business Name): ELIZABETH VU LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 BOREL PL UNIT 308
SAN MATEO CA
94402
US

IV. Provider business mailing address

1777 BOREL PL UNIT 308
SAN MATEO CA
94402
US

V. Phone/Fax

Practice location:
  • Phone: 650-540-7329
  • Fax:
Mailing address:
  • Phone: 650-540-7329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137811
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60565179
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16411
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: