Provider Demographics
NPI:1689109571
Name:CHEN, PATRICE ELAINE (DPT)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:ELAINE
Last Name:CHEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:ELAINE
Other - Last Name:JANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:39400 PASEO PADRE PKWY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2310
Mailing Address - Country:US
Mailing Address - Phone:510-248-3000
Mailing Address - Fax:
Practice Address - Street 1:3150 ALMADEN EXPY
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-1200
Practice Address - Country:US
Practice Address - Phone:408-540-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42874225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist