Provider Demographics
NPI:1114743473
Name:HSU, MAYA (MA, AMFT, APCC)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:HSU
Suffix:
Gender:F
Credentials:MA, AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 7TH ST UNIT 22018
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-6070
Mailing Address - Country:US
Mailing Address - Phone:650-281-3970
Mailing Address - Fax:
Practice Address - Street 1:3867 HOWE ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5343
Practice Address - Country:US
Practice Address - Phone:510-542-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17962101YM0800X
CA150372106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health