Healthcare Provider Details

I. General information

NPI: 1518821107
Provider Name (Legal Business Name): RYAN ZHU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 PARKCENTER DR STE 115
SANTA ANA CA
92705-3521
US

IV. Provider business mailing address

20804 MISSIONARY RIDGE ST
WALNUT CA
91789-4001
US

V. Phone/Fax

Practice location:
  • Phone: 888-745-6153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: