Healthcare Provider Details

I. General information

NPI: 1679017628
Provider Name (Legal Business Name): YUEH-CHING HSU PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2016
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAPS BLDG 599
SANTA BARBARA CA
93106-0001
US

IV. Provider business mailing address

2048 MALIBU DR
WEST LAFAYETTE IN
47906-5315
US

V. Phone/Fax

Practice location:
  • Phone: 805-893-4411
  • Fax:
Mailing address:
  • Phone: 352-222-5586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number20042792A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: