Provider Demographics
NPI:1710219969
Name:CHEN, YING-JU AMANDA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:YING-JU
Middle Name:AMANDA
Last Name:CHEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1142 S DIAMOND BAR BLVD
Mailing Address - Street 2:#209
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2203
Mailing Address - Country:US
Mailing Address - Phone:626-329-1661
Mailing Address - Fax:626-529-0098
Practice Address - Street 1:133 E BONITA AVE
Practice Address - Street 2:#200
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3173
Practice Address - Country:US
Practice Address - Phone:626-240-0794
Practice Address - Fax:626-529-0098
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CASP11838235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist