Healthcare Provider Details

I. General information

NPI: 1790455285
Provider Name (Legal Business Name): HUI-NI SHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2021
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3498 GREEN VALLEY RD
RESCUE CA
95672
US

IV. Provider business mailing address

965 BRIDGE ST APT 404
WEST SACRAMENTO CA
95691-3353
US

V. Phone/Fax

Practice location:
  • Phone: 530-391-8670
  • Fax:
Mailing address:
  • Phone: 412-519-2846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: