Healthcare Provider Details

I. General information

NPI: 1447382627
Provider Name (Legal Business Name): VICTORIA HUANGFU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 03/20/2018
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: 702-900-6561
  • Fax: 702-227-3915
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 19544
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0792
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: