Provider Demographics
NPI:1093868622
Name:HU, CATHRYN Y (PHD, OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:CATHRYN
Middle Name:Y
Last Name:HU
Suffix:
Gender:F
Credentials:PHD, OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 15TH ST STE 601
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1141
Mailing Address - Country:US
Mailing Address - Phone:310-458-2848
Mailing Address - Fax:310-458-2899
Practice Address - Street 1:1260 15TH ST STE 601
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1141
Practice Address - Country:US
Practice Address - Phone:310-458-2848
Practice Address - Fax:310-458-2899
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1353171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0013530Medicaid