Healthcare Provider Details

I. General information

NPI: 1821050162
Provider Name (Legal Business Name): WENDY YVETTE MAY SHEM O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WENDY YVETTE SHEM YEH O.D.

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1368 E WALNUT ST
PASADENA CA
91106-1528
US

IV. Provider business mailing address

1368 E WALNUT ST
PASADENA CA
91106-1528
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-3105
  • Fax: 626-796-8816
Mailing address:
  • Phone: 626-396-3105
  • Fax: 626-396-8816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number10731TPG
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number10731TPG
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10731TPG
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number10731TPG
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10731T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: