Provider Demographics
NPI:1043625916
Name:CHEN, CICELY (MD)
Entity Type:Individual
Prefix:DR
First Name:CICELY
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 GREENLEY RD, SUITE 922 ADVENTIST HEALTH (SIERRA OB/
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370
Mailing Address - Country:US
Mailing Address - Phone:209-536-3750
Mailing Address - Fax:209-532-9811
Practice Address - Street 1:900 GREENLEY RD, SUITE 922 ADVENTIST HEALTH (SIERRA OB/
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370
Practice Address - Country:US
Practice Address - Phone:209-536-3750
Practice Address - Fax:209-532-9811
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA153338207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology