Provider Demographics
NPI:1861996522
Name:LE, CHARLES HOANG
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:HOANG
Last Name:LE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 E KATELLA AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-5976
Mailing Address - Country:US
Mailing Address - Phone:888-725-7087
Mailing Address - Fax:
Practice Address - Street 1:1485 SARATOGA AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4965
Practice Address - Country:US
Practice Address - Phone:877-991-0009
Practice Address - Fax:877-207-9553
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-21-50735103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst