Provider Demographics
NPI:1073357513
Name:C. S. WU PSYCHOLOGICAL PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:C. S. WU PSYCHOLOGICAL PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:916-903-2568
Mailing Address - Street 1:4022 SUNRISE BLVD STE 120-370
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6911
Mailing Address - Country:US
Mailing Address - Phone:916-903-2568
Mailing Address - Fax:916-282-1613
Practice Address - Street 1:4022 SUNRISE BLVD STE 120-370
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6911
Practice Address - Country:US
Practice Address - Phone:916-903-2568
Practice Address - Fax:916-282-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty