Healthcare Provider Details

I. General information

NPI: 1861689820
Provider Name (Legal Business Name): LAURIE CHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 HOPYARD RD SUITE 140
PLEASANTON CA
94588-8528
US

IV. Provider business mailing address

3825 HOPYARD RD SUITE 140
PLEASANTON CA
94588-8528
US

V. Phone/Fax

Practice location:
  • Phone: 925-847-5051
  • Fax: 925-847-5593
Mailing address:
  • Phone: 925-847-5051
  • Fax: 925-847-5593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA101517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: