Provider Demographics
NPI:1194530113
Name:WU, HUNTINGTON ZONG RU (PPS, APCC)
Entity type:Individual
Prefix:
First Name:HUNTINGTON
Middle Name:ZONG RU
Last Name:WU
Suffix:
Gender:M
Credentials:PPS, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18600 LANARK ST
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-1233
Mailing Address - Country:US
Mailing Address - Phone:818-882-2496
Mailing Address - Fax:
Practice Address - Street 1:18600 LANARK ST
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-1233
Practice Address - Country:US
Practice Address - Phone:818-882-2496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12057101YM0800X
CA220222741101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health