Provider Demographics
NPI:1194373423
Name:HYUN, CHRISTY K (MFT)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:K
Last Name:HYUN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5339 PROSPECT RD # 202
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5033
Mailing Address - Country:US
Mailing Address - Phone:818-307-2935
Mailing Address - Fax:
Practice Address - Street 1:2431 PARK BLVD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1931
Practice Address - Country:US
Practice Address - Phone:818-307-2935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46787106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist