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General NPI Number Information
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NPI Number | 1073357513
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Entity Type | Organization
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Legal Business Name | C. S. WU PSYCHOLOGICAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 4022 SUNRISE BLVD STE 120-370
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City | RANCHO CORDOVA
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State | CA
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Zip | 95742-6911
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Country | US
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Telephone | 916-903-2568
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Fax | 916-282-1613
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Provider Business Mailing Address
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Address Line | 4022 SUNRISE BLVD STE 120-370
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City | RANCHO CORDOVA
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State | CA
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Zip | 95742-6911
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Country | US
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Telephone | 916-903-2568
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Fax | 916-282-1613
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. CHRISTINE S WU
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Credential | PSYD
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Telephone | 916-903-2568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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