Provider Demographics
NPI:1245848910
Name:KU, WEN-HSIN
Entity type:Individual
Prefix:MS
First Name:WEN-HSIN
Middle Name:
Last Name:KU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14781 POMERADO RD # 106
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2802
Mailing Address - Country:US
Mailing Address - Phone:858-324-4788
Mailing Address - Fax:
Practice Address - Street 1:9520 PADGETT ST STE 104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4446
Practice Address - Country:US
Practice Address - Phone:858-866-8133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist