Provider Demographics
NPI:1972364834
Name:HA, QUY
Entity Type:Individual
Prefix:
First Name:QUY
Middle Name:
Last Name:HA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MIKE
Other - Middle Name:
Other - Last Name:HA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3947 LENNANE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1971
Mailing Address - Country:US
Mailing Address - Phone:916-283-8280
Mailing Address - Fax:
Practice Address - Street 1:3947 LENNANE DR STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1971
Practice Address - Country:US
Practice Address - Phone:916-283-8280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical