Basic Information
| Provider Information | |||||||||
| NPI: | 1447660477 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HU | ||||||||
| FirstName: | ENKUAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | CERTIFIED THERAPIST | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 SUNNYVALE SARATOGA RD STE B2 | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4088881635 | ||||||||
| FaxNumber: | 4082611111 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 SUNNYVALE SARATOGA RD STE B2 | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4088881635 | ||||||||
| FaxNumber: | 4082611111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2014 | ||||||||
| LastUpdateDate: | 04/29/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 26957 | CA | Y | Other Service Providers | Specialist | 174400000X | AC6620 | CA | N | Other Service Providers | Specialist |
No ID Information.