Provider Demographics
NPI:1881831337
Name:CHEN, WENDY JENWEI (DC, LAC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:JENWEI
Last Name:CHEN
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E LA SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-4351
Mailing Address - Country:US
Mailing Address - Phone:626-215-2958
Mailing Address - Fax:
Practice Address - Street 1:412 E LA SIERRA DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-4351
Practice Address - Country:US
Practice Address - Phone:626-215-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30899111N00000X
CAAC11933171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist