Provider Demographics
NPI:1063796217
Name:CHU, DANIEL RYAN
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:RYAN
Last Name:CHU
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 1:6850 SHARLANDS AVE UNIT P2090
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-2775
Mailing Address - Country:US
Mailing Address - Phone:650-922-5165
Mailing Address - Fax:
Practice Address - Street 1:1101 W MOANA LN STE 2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4734
Practice Address - Country:US
Practice Address - Phone:775-337-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst