MEDICARE: ALICE BING CHEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS18628	CA

General Provider Information

NPI Number	:	1548322969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE BING CHEN LCSW

Provider Business Mailing Address
First Line	:	3505 BROADWAY
Second Line	:	4TH FLOOR
City	:	OAKLAND
State	:	CA
Zip	:	94611-5714
Country	:	US
Telephone Number	:	510-752-8299
Fax Number	:	510-752-1404

Provider Business Practice Location Address
First Line	:	3505 BROADWAY
Second Line	:	4TH FLOOR
City	:	OAKLAND
State	:	CA
Zip	:	94611-5714
Country	:	US
Telephone Number	:	510-752-8299
Fax Number	:	510-752-1404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	01/03/2022

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