Provider Demographics
NPI:1497200026
Name:HSU, AZADA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:AZADA
Middle Name:
Last Name:HSU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 MIRA VALLE ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5328
Mailing Address - Country:US
Mailing Address - Phone:626-679-0011
Mailing Address - Fax:
Practice Address - Street 1:1790 MIRA VALLE ST
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-5328
Practice Address - Country:US
Practice Address - Phone:626-679-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19689225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist