Provider Demographics
NPI:1740524602
Name:CHEN, YUN - CHIH (AUD)
Entity type:Individual
Prefix:DR
First Name:YUN - CHIH
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S ELLSWORTH AVE
Mailing Address - Street 2:STE 711
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3939
Mailing Address - Country:US
Mailing Address - Phone:650-579-4470
Mailing Address - Fax:650-579-4471
Practice Address - Street 1:100 S ELLSWORTH AVE
Practice Address - Street 2:STE 711
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3939
Practice Address - Country:US
Practice Address - Phone:650-579-4470
Practice Address - Fax:650-579-4471
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80439231H00000X
CAAU3075231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist