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General NPI Number Information
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NPI Number | 1689028698
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Entity Type | Individual
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Provider Name | CHINAENYEZE KUBA
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Gender | Male
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Dates
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Enumeration Date | 04/15/2016
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 14820 MCVAY AVE
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City | SAN JOSE
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State | CA
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Zip | 95127-2540
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Country | US
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Telephone | 408-258-7343
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 SOUTHWEST EXPY APT 65
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City | SAN JOSE
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State | CA
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Zip | 95126-4641
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Country | US
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Telephone | 408-561-2214
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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