Healthcare Provider Details

I. General information

NPI: 1891059374
Provider Name (Legal Business Name): ANGELA CHIA-YI WERNOW O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 GARDEN VIEW CT STE 100
ENCINITAS CA
92024-2478
US

IV. Provider business mailing address

14726 RAMONA AVE STE 203
CHINO CA
91710-5730
US

V. Phone/Fax

Practice location:
  • Phone: 760-452-4270
  • Fax: 760-452-5328
Mailing address:
  • Phone: 626-305-9100
  • Fax: 626-305-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35393
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3301
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: