Provider Demographics
NPI:1548318769
Name:HA, SIU K (LCSW)
Entity type:Individual
Prefix:
First Name:SIU
Middle Name:K
Last Name:HA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19000 HOMESTEAD RD FL 2
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-0712
Mailing Address - Country:US
Mailing Address - Phone:408-336-4402
Mailing Address - Fax:408-336-4405
Practice Address - Street 1:19000 HOMESTEAD RD FL 2
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-0712
Practice Address - Country:US
Practice Address - Phone:408-336-4402
Practice Address - Fax:408-336-4405
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 174881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical