Healthcare Provider Details

I. General information

NPI: 1801750294
Provider Name (Legal Business Name): CRYSTAL CHENG HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 TANGLEWOOD DR
WEST COVINA CA
91791-4093
US

IV. Provider business mailing address

1903 TANGLEWOOD DR
WEST COVINA CA
91791-4093
US

V. Phone/Fax

Practice location:
  • Phone: 626-567-5998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number135527
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: