Healthcare Provider Details

I. General information

NPI: 1417115114
Provider Name (Legal Business Name): BAI-YIN CHEN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE SHIELDS AVE COUNSELING AND PSYCHOLOGICAL SERVICES 219 NORTH HALL
DAVIS CA
95616-8568
US

IV. Provider business mailing address

ONE SHIELDS AVE COUNSELING AND PSYCHOLOGICAL SERVICES 219 NORTH HALL
DAVIS CA
95616-8568
US

V. Phone/Fax

Practice location:
  • Phone: 530-752-0871
  • Fax: 530-752-9923
Mailing address:
  • Phone: 530-752-0871
  • Fax: 530-752-9923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 21954
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY 21954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: