Provider Demographics
NPI:1770648784
Name:CHEN, YAUSHI B (OD)
Entity Type:Individual
Prefix:
First Name:YAUSHI
Middle Name:B
Last Name:CHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SERRA WAY
Mailing Address - Street 2:#128
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-8519
Mailing Address - Country:US
Mailing Address - Phone:408-262-8998
Mailing Address - Fax:408-262-8249
Practice Address - Street 1:61 SERRA WAY
Practice Address - Street 2:#128
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-8519
Practice Address - Country:US
Practice Address - Phone:408-262-8998
Practice Address - Fax:408-262-8249
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13453152W00000X
WI3034-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38629300Medicaid
WIV08871Medicare UPIN
WI38629300Medicaid