Healthcare Provider Details

I. General information

NPI: 1346799905
Provider Name (Legal Business Name): HUANGFU PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 S JONES BLVD STE D3
LAS VEGAS NV
89103-3370
US

IV. Provider business mailing address

4425 S JONES BLVD STE D3
LAS VEGAS NV
89103-3370
US

V. Phone/Fax

Practice location:
  • Phone: 702-685-0674
  • Fax: 702-566-4575
Mailing address:
  • Phone: 702-685-0674
  • Fax: 702-566-4575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPYT160725
License Number StateNV

VIII. Authorized Official

Name: DR. VICTORIA HUANGFU
Title or Position: OWNER
Credential: PSY.D
Phone: 702-685-0674