Healthcare Provider Details

I. General information

NPI: 1164882940
Provider Name (Legal Business Name): AMY LEE HUANG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2016
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 PLAZA DEL AMO
TORRANCE CA
90501-5267
US

IV. Provider business mailing address

1626 PLAZA DEL AMO
TORRANCE CA
90501-5267
US

V. Phone/Fax

Practice location:
  • Phone: 909-270-6656
  • Fax: 909-606-7944
Mailing address:
  • Phone: 909-270-6656
  • Fax: 909-606-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number62480
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW78087
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: