Provider Demographics
NPI:1851083877
Name:ALMACEN, CHEN MENDOZA JR
Entity Type:Individual
Prefix:
First Name:CHEN
Middle Name:MENDOZA
Last Name:ALMACEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 BONNEVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-2887
Mailing Address - Country:US
Mailing Address - Phone:310-951-0822
Mailing Address - Fax:
Practice Address - Street 1:4435 BONNEVILLE CIR
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2887
Practice Address - Country:US
Practice Address - Phone:310-951-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT24783225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist