Provider Demographics
NPI:1063456101
Name:LEUNG, WENDY SETO (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SETO
Last Name:LEUNG
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 WILSHIRE BLVD
Mailing Address - Street 2:#240
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3809
Mailing Address - Country:US
Mailing Address - Phone:215-431-4702
Mailing Address - Fax:
Practice Address - Street 1:4650 SUNSET BLVD
Practice Address - Street 2:MAIL STOP #54
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6016
Practice Address - Country:US
Practice Address - Phone:323-361-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 19401363LP0200X
PASP008037363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics