Provider Demographics
NPI:1376880773
Name:CHEN, ENFFIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ENFFIE
Middle Name:
Last Name:CHEN
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 1:6140 E SANTA ANA CANYON RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2302
Mailing Address - Country:US
Mailing Address - Phone:714-271-9749
Mailing Address - Fax:
Practice Address - Street 1:350 S 8TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2242
Practice Address - Country:US
Practice Address - Phone:541-259-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR296963225X00000X
CA12790225X00000X
WA60314874225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist