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General NPI Number Information
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NPI Number | 1598605602
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Entity Type | Individual
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Provider Name | CHANGLE SU
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Gender | Female
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 1 W CAMPBELL AVE STE D36
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City | CAMPBELL
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State | CA
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Zip | 95008-1041
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Country | US
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Telephone | 669-667-9267
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Fax |
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Provider Business Mailing Address
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Address Line | 10624 GASCOIGNE DR
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City | CUPERTINO
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State | CA
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Zip | 95014-3844
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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