Provider Demographics
NPI:1104686914
Name:KWAN, JOYCE HO-HUEN
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:HO-HUEN
Last Name:KWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25521 FOGGY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-5502
Mailing Address - Country:US
Mailing Address - Phone:510-561-8301
Mailing Address - Fax:
Practice Address - Street 1:25521 FOGGY GLEN DR
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-5502
Practice Address - Country:US
Practice Address - Phone:510-561-8301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician