Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor |
NPI | 1003255209 |
---|---|
Provider Name | Wayne Xu |
First Address | San Francisco, CA 94102-5610 |
Second Address | San Francisco, CA 94102-5610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2013 |
Last Update Date | 28/12/2021 |