Provider Demographics
NPI:1356699532
Name:PHAN-CHU, ANH THI (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ANH
Middle Name:THI
Last Name:PHAN-CHU
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12881 KNOTT ST STE 240
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-3943
Mailing Address - Country:US
Mailing Address - Phone:657-500-9177
Mailing Address - Fax:714-707-4234
Practice Address - Street 1:12881 KNOTT ST STE 240
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-3943
Practice Address - Country:US
Practice Address - Phone:657-500-9177
Practice Address - Fax:714-707-4234
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst