Healthcare Provider Details

I. General information

NPI: 1952887499
Provider Name (Legal Business Name): MAKAELA CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PASTEUR STE 100
IRVINE CA
92618-3813
US

IV. Provider business mailing address

239 PINESTONE
IRVINE CA
92604-4719
US

V. Phone/Fax

Practice location:
  • Phone: 949-788-9236
  • Fax:
Mailing address:
  • Phone: 949-842-8972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number28512
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: