Provider Demographics
NPI:1821050162
Name:SHEM, WENDY YVETTE MAY (OD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:YVETTE MAY
Last Name:SHEM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:YVETTE SHEM
Other - Last Name:YEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1368 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1528
Mailing Address - Country:US
Mailing Address - Phone:626-396-3105
Mailing Address - Fax:626-396-8816
Practice Address - Street 1:1368 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1528
Practice Address - Country:US
Practice Address - Phone:626-796-3105
Practice Address - Fax:626-796-8816
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10731TPG152WC0802X, 152WS0006X, 152W00000X, 152WV0400X
CA10731T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1821050162Medicaid