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3775 Beacon Ave Suite 208 Fremont CA 94538-1465 | |
| (510) 449-3386 | |
| (855) 244-3594 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3775 Beacon Ave, Fremont, California |
| Authorized Official Name and Position | Grace S Ho (CFO) |
| Authorized Official Contact | 5104493386 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3775 Beacon Ave Suite 208 Fremont CA 94538-1465 Ph: (510) 449-3386 | 3775 Beacon Ave Suite 208 Fremont CA 94538-1465 Ph: (510) 449-3386 |
| NPI Number | 1376707141 |
|---|---|
| Provider Enumeration Date | 07/11/2008 |
| Last Update Date | 05/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376707141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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