Provider Demographics
NPI:1730487893
Name:WANG, WENDY (ND)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 E DUARTE RD
Mailing Address - Street 2:#A
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3993
Mailing Address - Country:US
Mailing Address - Phone:626-215-3214
Mailing Address - Fax:626-445-0288
Practice Address - Street 1:145 E DUARTE RD
Practice Address - Street 2:#A
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3993
Practice Address - Country:US
Practice Address - Phone:626-215-3214
Practice Address - Fax:626-445-0288
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-371175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath