Healthcare Provider Details

I. General information

NPI: 1215846332
Provider Name (Legal Business Name): GINA FU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27000 WEYERHAUSER WAY
SANTA CLARITA CA
91351-4947
US

IV. Provider business mailing address

24007 DANDELION LN
VALENCIA CA
91354-1849
US

V. Phone/Fax

Practice location:
  • Phone: 661-252-2100
  • Fax:
Mailing address:
  • Phone: 661-600-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: