Healthcare Provider Details

I. General information

NPI: 1740895671
Provider Name (Legal Business Name): JOYLEEN TA-JUNG HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 09/08/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 CALIFORNIA ST STE 660
SAN FRANCISCO CA
94104-1845
US

IV. Provider business mailing address

99 VISTA MONTANA APT 4525
SAN JOSE CA
95134-2395
US

V. Phone/Fax

Practice location:
  • Phone: 425-525-9082
  • Fax:
Mailing address:
  • Phone: 425-525-9082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: