Provider Demographics
NPI:1578376141
Name:WU, HUNG YI
Entity type:Individual
Prefix:
First Name:HUNG YI
Middle Name:
Last Name:WU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 N DIAMOND BAR BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1059
Mailing Address - Country:US
Mailing Address - Phone:909-396-8900
Mailing Address - Fax:
Practice Address - Street 1:706 N DIAMOND BAR BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1059
Practice Address - Country:US
Practice Address - Phone:909-396-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-02-20
Deactivation Date:2025-01-28
Deactivation Code:
Reactivation Date:2025-02-20
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist