Provider Demographics
NPI:1023461175
Name:CHENG, RYU (LCSW)
Entity type:Individual
Prefix:
First Name:RYU
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 WEBSTER STREET
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4707
Mailing Address - Country:US
Mailing Address - Phone:510-685-6800
Mailing Address - Fax:510-986-6896
Practice Address - Street 1:818 WEBSTER STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4707
Practice Address - Country:US
Practice Address - Phone:510-685-6800
Practice Address - Fax:510-986-6896
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA804171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical