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120 Santa Margarita Ave Bldg B Menlo Park CA 94025-2725 | |
| (650) 727-1523 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 120 Santa Margarita Ave Bldg B, Menlo Park, California |
| Authorized Official Name and Position | Yang N/a Xu (PRESIDENT) |
| Authorized Official Contact | 6507271523 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
530 Lytton Ave Fl 2 Palo Alto CA 94301-1541 Ph: () - | 120 Santa Margarita Ave Bldg B Menlo Park CA 94025-2725 Ph: (650) 727-1523 |
| NPI Number | 1659147940 |
|---|---|
| Provider Enumeration Date | 11/28/2023 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659147940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
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