Healthcare Provider Details

I. General information

NPI: 1306570429
Provider Name (Legal Business Name): HUI YU WEN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE WEN DPT, NCS

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22103 REDWOOD RD
CASTRO VALLEY CA
94546-7107
US

IV. Provider business mailing address

5989 HILLBROOK PL
DUBLIN CA
94568-7313
US

V. Phone/Fax

Practice location:
  • Phone: 510-537-8848
  • Fax:
Mailing address:
  • Phone: 312-720-2275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT302054
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: