Healthcare Provider Details

I. General information

NPI: 1093366270
Provider Name (Legal Business Name): WENHSIN CHANG PH.D., L.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2019
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 THORN ST
SAN DIEGO CA
92103-5629
US

IV. Provider business mailing address

4653 CARMEL MOUNTAIN RD STE 308 #AA314
SAN DIEGO CA
92130-6650
US

V. Phone/Fax

Practice location:
  • Phone: 619-354-7400
  • Fax:
Mailing address:
  • Phone: 619-376-2325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY32489
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number084778
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: