Provider Demographics
NPI:1619233392
Name:CHU, CHENG TING (BCBA)
Entity Type:Individual
Prefix:MR
First Name:CHENG
Middle Name:TING
Last Name:CHU
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 HARLOW LN
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5790
Mailing Address - Country:US
Mailing Address - Phone:408-807-0918
Mailing Address - Fax:
Practice Address - Street 1:2571 HARLOW LN
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-5790
Practice Address - Country:US
Practice Address - Phone:408-807-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst