Healthcare Provider Details

I. General information

NPI: 1699036582
Provider Name (Legal Business Name): YUCUI CHEN M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3933 HARRISON ST
RIVERSIDE CA
92503-3523
US

IV. Provider business mailing address

231 E ALESSANDRO BLVD # A238
RIVERSIDE CA
92508-5084
US

V. Phone/Fax

Practice location:
  • Phone: 833-391-0505
  • Fax:
Mailing address:
  • Phone: 951-441-4306
  • Fax: 888-724-3702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number132294
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA132294
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: