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NICOLAS CHU
Clinical >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1912339540
Individual Registrant: NICOLAS CHU
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
21 TAMAL VISTA BLVD STE 162 CORTE MADERA, CA 94925-1146 US
Tel: 415-233-7990 Fax: --
Tel: 415-233-7990 Fax: --
Contact information for business:
21 TAMAL VISTA BLVD STE 162 CORTE MADERA, CA 94925-1146 US
Tel: 415-233-7990 Fax: --
Tel: 415-233-7990 Fax: --
Registration Information:
NPI: 1912339540
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist Clinical | CA | PSY29056 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
