Provider Demographics
NPI:1114276755
Name:CHEN, ALEXIS (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W PORTAL AVE DEPT OF
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1412
Mailing Address - Country:US
Mailing Address - Phone:415-800-7674
Mailing Address - Fax:
Practice Address - Street 1:312 W PORTAL AVE DEPT OF
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1412
Practice Address - Country:US
Practice Address - Phone:415-800-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1380225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist