Healthcare Provider Details

I. General information

NPI: 1437077518
Provider Name (Legal Business Name): WING SHAN WENDY LI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 E HILLSDALE BLVD
FOSTER CITY CA
94404-1241
US

IV. Provider business mailing address

40443 GIBSON ST
FREMONT CA
94538-2855
US

V. Phone/Fax

Practice location:
  • Phone: 650-918-5080
  • Fax:
Mailing address:
  • Phone: 510-378-0321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95036718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: