Provider Demographics
NPI:1982870432
Name:HAN, AN TINA (MHRS)
Entity Type:Individual
Prefix:
First Name:AN
Middle Name:TINA
Last Name:HAN
Suffix:
Gender:F
Credentials:MHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 E SANTA CLARA ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-2244
Mailing Address - Country:US
Mailing Address - Phone:408-792-2109
Mailing Address - Fax:408-298-0192
Practice Address - Street 1:1075 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2244
Practice Address - Country:US
Practice Address - Phone:408-792-2109
Practice Address - Fax:408-298-0192
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health