Provider Demographics
NPI:1912626029
Name:ANGELINE HSU THERAPY
Entity Type:Organization
Organization Name:ANGELINE HSU THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-674-3499
Mailing Address - Street 1:242 S ORANGE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-7915
Mailing Address - Country:US
Mailing Address - Phone:909-529-8013
Mailing Address - Fax:
Practice Address - Street 1:242 S ORANGE AVE STE 201
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-7915
Practice Address - Country:US
Practice Address - Phone:909-529-8013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty