Provider Demographics
NPI:1154533602
Name:HO, GRACE S (PSYD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:S
Last Name:HO
Suffix:
Gender:F
Credentials:PSYD
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Mailing Address - Street 1:3775 BEACON AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1465
Mailing Address - Country:US
Mailing Address - Phone:510-449-3386
Mailing Address - Fax:855-244-3594
Practice Address - Street 1:3775 BEACON AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1465
Practice Address - Country:US
Practice Address - Phone:510-449-3386
Practice Address - Fax:855-244-3594
Is Sole Proprietor?:No
Enumeration Date:2007-05-05
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20942103TC0700X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACN052ZMedicare PIN