Provider Demographics
NPI:1245879329
Name:PAN, TSUEYHWA (LCSW)
Entity type:Individual
Prefix:MS
First Name:TSUEYHWA
Middle Name:
Last Name:PAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SARINA
Other - Middle Name:
Other - Last Name:PAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1144 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-3422
Mailing Address - Country:US
Mailing Address - Phone:626-512-0531
Mailing Address - Fax:
Practice Address - Street 1:941 S ATLANTIC BLVD STE 221
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4722
Practice Address - Country:US
Practice Address - Phone:626-284-3926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW885061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical