Healthcare Provider Details

I. General information

NPI: 1073705117
Provider Name (Legal Business Name): JULIA YU WEN SHIH M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YU WEN YU WEN SHIH AUD

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST STE 208
PASADENA CA
91106-2401
US

IV. Provider business mailing address

4140 W 190TH ST # 101
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 646-796-4535
  • Fax: 646-796-4935
Mailing address:
  • Phone: 626-796-4535
  • Fax: 626-796-4935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA1953
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: