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General NPI Number Information
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NPI Number | 1811626823
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Entity Type | Individual
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Provider Name | JIA YI SU
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Gender | Female
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 457 KNOLLCREST DR
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City | REDDING
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State | CA
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Zip | 96002-0121
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Country | US
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Telephone | 530-392-4399
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Fax | 530-903-4226
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Provider Business Mailing Address
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Address Line | 3838 TURQUOISE WAY UNIT 223
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City | OAKLAND
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State | CA
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Zip | 94609-2869
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Country | US
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Telephone | 510-332-8873
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | CA
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