Provider Demographics
NPI:1114434453
Name:WU, SHIH-YA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHIH-YA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 ARTESIA BLVD APT 118
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-3360
Mailing Address - Country:US
Mailing Address - Phone:626-715-9167
Mailing Address - Fax:
Practice Address - Street 1:3655 ARTESIA BLVD APT 118
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-3360
Practice Address - Country:US
Practice Address - Phone:626-715-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17972225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist