Provider Demographics
NPI:1780121426
Name:HUYNH, KATHY (LCSW)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 11TH STREET
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4841
Mailing Address - Country:US
Mailing Address - Phone:510-250-8300
Mailing Address - Fax:510-250-8348
Practice Address - Street 1:190 11TH STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4841
Practice Address - Country:US
Practice Address - Phone:510-250-8300
Practice Address - Fax:510-250-8348
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW930781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical