Healthcare Provider Details

I. General information

NPI: 1831027267
Provider Name (Legal Business Name): FAITH XIONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 S KING RD
SAN JOSE CA
95122-2146
US

IV. Provider business mailing address

1250 S KING RD
SAN JOSE CA
95122-2146
US

V. Phone/Fax

Practice location:
  • Phone: 408-251-5600
  • Fax:
Mailing address:
  • Phone: 510-820-4056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number250068116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: