Provider Demographics
NPI:1053731976
Name:JIE, HOICHING
Entity type:Individual
Prefix:
First Name:HOICHING
Middle Name:
Last Name:JIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JUSTIN
Other - Middle Name:
Other - Last Name:JIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:310 8TH ST
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-6526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 8TH ST
Practice Address - Street 2:SUITE 200A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6526
Practice Address - Country:US
Practice Address - Phone:510-735-3900
Practice Address - Fax:510-474-1715
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAIMF 95577101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program