Provider Demographics
NPI:1891336798
Name:HUANG, JOHN C (SLP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:HUANG
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 STONECREST PL
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4330
Mailing Address - Country:US
Mailing Address - Phone:909-632-8299
Mailing Address - Fax:
Practice Address - Street 1:1431 STONECREST PL
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4330
Practice Address - Country:US
Practice Address - Phone:909-632-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15449235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist