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NPI Code Detail

MEDICARE: KENT PHU SU AMFT

MEDICARE: KENT PHU SU AMFT
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
1106H00000XMarriage & Family TherapistAMFT161079CA

General Provider Information

NPI Number : 1437007473
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENT PHU SU AMFT
Provider Business Mailing Address
First Line : 1635 W MAIN ST STE 100
Second Line :
City : ALHAMBRA
State : CA
Zip : 91801-1951
Country : US
Telephone Number : 626-248-1800
Fax Number : 626-248-1899
Provider Business Practice Location Address
First Line : 1635 W MAIN ST STE 100
Second Line :
City : ALHAMBRA
State : CA
Zip : 91801-1951
Country : US
Telephone Number : 626-248-1800
Fax Number : 626-248-1899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/17/2026

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Directions to “ KENT PHU SU AMFT” Practice Location

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