Provider Demographics
NPI:1033317409
Name:WU, SHIH SHIN (LCSW)
Entity Type:Individual
Prefix:
First Name:SHIH SHIN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHIH SHIN
Other - Middle Name:SUZIE
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:631 SAN CARLOS AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1435
Mailing Address - Country:US
Mailing Address - Phone:917-209-3487
Mailing Address - Fax:
Practice Address - Street 1:405 KAINS AVE STE 107
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1259
Practice Address - Country:US
Practice Address - Phone:917-209-3487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY55526831041C0700X
CALCSW891381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical