Basic Information
| Provider Information | |||||||||
| NPI: | 1407376791 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUACH | ||||||||
| FirstName: | HONG | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9353 VALLEY BLVD STE C | ||||||||
| Address2: | |||||||||
| City: | ROSEMEAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917701934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262872988 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9960 BALDWIN PL | ||||||||
| Address2: | |||||||||
| City: | EL MONTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917312204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6267742988 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2017 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.