MEDICARE: DANIELLE WU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	26604	CA

General Provider Information

NPI Number	:	1285867598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE WU

Provider Business Mailing Address
First Line	:	PO BOX 2432
Second Line	:
City	:	NOVATO
State	:	CA
Zip	:	94948-2432
Country	:	US
Telephone Number	:	415-939-5224
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440A HYDE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-3135
Country	:	US
Telephone Number	:	415-939-5224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	05/19/2015

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Directions to “ DANIELLE WU ” Practice Location

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