Provider Demographics
NPI:1750812384
Name:CHEN, SUSANA WING YEE (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:WING YEE
Last Name:CHEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35160 RAMBLEWOOD COURT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536
Mailing Address - Country:US
Mailing Address - Phone:510-364-8063
Mailing Address - Fax:
Practice Address - Street 1:3553 WHIPPLE ROAD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587
Practice Address - Country:US
Practice Address - Phone:510-675-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist