Provider Demographics
NPI:1790085405
Name:KOO, HYANG CHRIS (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:HYANG
Middle Name:CHRIS
Last Name:KOO
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 WATERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-1736
Mailing Address - Country:US
Mailing Address - Phone:650-802-8699
Mailing Address - Fax:
Practice Address - Street 1:98 WATERSIDE CIR
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-1736
Practice Address - Country:US
Practice Address - Phone:650-802-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-7177103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst