Provider Demographics
NPI:1073705117
Name:SHIH, JULIA YU WEN (MA)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:YU WEN
Last Name:SHIH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:YU WEN
Other - Middle Name:YU WEN
Other - Last Name:SHIH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:4140 W 190TH ST # 101
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:626-796-4535
Mailing Address - Fax:626-796-4935
Practice Address - Street 1:960 E GREEN ST STE 208
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:646-796-4535
Practice Address - Fax:646-796-4935
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA1953237700000X
CAAU868231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0019530Medicaid
ZZZ20301ZOtherBLUE SHIELD
CAAU0008680Medicaid
ZZZ20299ZOtherBLUE SHIELD
ZZZ20301ZOtherBLUE SHIELD
ZZZ20299ZOtherBLUE SHIELD
CAAU0008680Medicaid