Provider Demographics
NPI:1013402429
Name:KAO, JUIHSIEN HUNG
Entity Type:Individual
Prefix:
First Name:JUIHSIEN
Middle Name:HUNG
Last Name:KAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 UNIVERSITY AVE NE STE 209
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3151
Mailing Address - Country:US
Mailing Address - Phone:612-400-7914
Mailing Address - Fax:612-464-6595
Practice Address - Street 1:7362 UNIVERSITY AVE NE STE 209
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3151
Practice Address - Country:US
Practice Address - Phone:612-400-7914
Practice Address - Fax:612-464-6595
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5508103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty