Provider Demographics
NPI:1467660092
Name:HSU, JONATHAN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9584 PENTLAND ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3844
Mailing Address - Country:US
Mailing Address - Phone:626-272-3679
Mailing Address - Fax:
Practice Address - Street 1:2440 S HACIENDA BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4775
Practice Address - Country:US
Practice Address - Phone:626-537-9775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT50913106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist