1982118261 NPI number — SHUJUNG HUNG LAC

Table of content: MICHELE ANNETTE WALKER BSW (NPI 1023444148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982118261 NPI number — SHUJUNG HUNG LAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNG
Provider First Name:
SHUJUNG
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUNG
Provider Other First Name:
MELINDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LAC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1982118261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2820 RIVERA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURLINGAME
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94010-5832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-732-2158
Provider Business Mailing Address Fax Number:
650-305-7831

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
441 DE GUIGNE DR STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYVALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94085-3875
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-732-2158
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/26/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  17900 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)