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General NPI Number Information
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NPI Number | 1871957829
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Entity Type | Individual
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Provider Name | KATHLEEN HUA
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Gender | Female
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1513 S GRAND AVE STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90015-3075
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Country | US
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Telephone | 833-438-8763
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Fax | 833-438-8700
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Provider Business Mailing Address
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Address Line | 150 MUIR RD
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City | MARTINEZ
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State | CA
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Zip | 94553-4668
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Country | US
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Telephone | 169-843-6804
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20084
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License Number State | CA
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