Provider Demographics
NPI:1457646929
Name:CORNWELL-CHIU, VANESSA CHIH YUEH (DPT)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:CHIH YUEH
Last Name:CORNWELL-CHIU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 NUT TREE RD STE 260
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4100
Mailing Address - Country:US
Mailing Address - Phone:707-624-8290
Mailing Address - Fax:707-624-7362
Practice Address - Street 1:1020 NUT TREE RD STE 260
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4100
Practice Address - Country:US
Practice Address - Phone:707-624-8290
Practice Address - Fax:707-624-7362
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT37853225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist