Individual
JACOB LUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25281 PARK AVE APT L2, LOMA LINDA, CA 92354-2373
(626) 720-9178
Mailing address
11130 ANDERSON ST, LOMA LINDA, CA 92350-1729
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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