Provider Demographics
NPI:1912186198
Name:HUI, JESSICA C (PH D)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:C
Last Name:HUI
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 W COLLEGE ST STE 204
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1925
Mailing Address - Country:US
Mailing Address - Phone:626-858-5098
Mailing Address - Fax:
Practice Address - Street 1:246 W COLLEGE ST STE 204
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1925
Practice Address - Country:US
Practice Address - Phone:626-858-5098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5964171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3311933Medicare PIN