Provider Demographics
NPI:1205900701
Name:DENG, CHIAOWEN (MA, EDM)
Entity type:Individual
Prefix:MS
First Name:CHIAOWEN
Middle Name:
Last Name:DENG
Suffix:
Gender:F
Credentials:MA, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 DWIGHT WAY APT 12
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-3132
Mailing Address - Country:US
Mailing Address - Phone:510-649-6964
Mailing Address - Fax:
Practice Address - Street 1:720 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-2505
Practice Address - Country:US
Practice Address - Phone:415-867-4425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF51494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health