Provider Demographics
NPI:1578691754
Name:TUNG, VICTORIA H (RD, CNSC, PA-C)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:H
Last Name:TUNG
Suffix:
Gender:F
Credentials:RD, CNSC, PA-C
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:HUICHUNG WU
Other - Last Name:TUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:39350 CIVIC CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2343
Mailing Address - Country:US
Mailing Address - Phone:510-797-3933
Mailing Address - Fax:510-797-5184
Practice Address - Street 1:39350 CIVIC CENTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2343
Practice Address - Country:US
Practice Address - Phone:510-797-3933
Practice Address - Fax:510-797-5184
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA836494133V00000X
CA22893363A00000X
CAPA22893363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA22893OtherCA LICENSE