Provider Demographics
NPI:1710456744
Name:CHEN, CHIA WEI
Entity Type:Individual
Prefix:
First Name:CHIA WEI
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CALLAN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4523
Mailing Address - Country:US
Mailing Address - Phone:510-547-2662
Mailing Address - Fax:
Practice Address - Street 1:101 CALLAN AVE STE 400
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4523
Practice Address - Country:US
Practice Address - Phone:510-547-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist