Provider Demographics
NPI:1508127994
Name:HSU, YI-CHUN (PSY D)
Entity Type:Individual
Prefix:
First Name:YI-CHUN
Middle Name:
Last Name:HSU
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 952
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95759-0952
Mailing Address - Country:US
Mailing Address - Phone:626-217-5235
Mailing Address - Fax:
Practice Address - Street 1:7650 NEWCASTLE RD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95215-9663
Practice Address - Country:US
Practice Address - Phone:626-217-5235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic