Provider Demographics
NPI:1093378481
Name:LE, TO NHU H (PPSC)
Entity Type:Individual
Prefix:
First Name:TO NHU
Middle Name:H
Last Name:LE
Suffix:
Gender:F
Credentials:PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 S ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-1020
Mailing Address - Country:US
Mailing Address - Phone:714-867-8616
Mailing Address - Fax:
Practice Address - Street 1:2063 S SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-4833
Practice Address - Country:US
Practice Address - Phone:657-456-8558
Practice Address - Fax:833-256-3911
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-21
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 106S00000X, 103K00000X
CA1501594901041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician