Provider Demographics
NPI:1932740768
Name:KWOK, ALEX KING CHIU
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:KING CHIU
Last Name:KWOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 SANTA CLARA AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-2738
Mailing Address - Country:US
Mailing Address - Phone:510-769-8040
Mailing Address - Fax:
Practice Address - Street 1:1151 A ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4113
Practice Address - Country:US
Practice Address - Phone:510-901-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0837875106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician