Provider Demographics
NPI:1912342882
Name:LI HOU, DONG (LCSW)
Entity type:Individual
Prefix:
First Name:DONG
Middle Name:
Last Name:LI HOU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 CAPITOL AVE.
Mailing Address - Street 2:BUILDING B. P.O.BOX 5006
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94537-5006
Mailing Address - Country:US
Mailing Address - Phone:510-574-2173
Mailing Address - Fax:
Practice Address - Street 1:3300 CAPITOL AVE BLDG B
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1514
Practice Address - Country:US
Practice Address - Phone:650-573-3616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA270071041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical