Healthcare Provider Details

I. General information

NPI: 1376335836
Provider Name (Legal Business Name): WANQING CHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 FILBERT ST
SAN FRANCISCO CA
94133-2760
US

IV. Provider business mailing address

524 CLEMENT ST APT 3
SAN FRANCISCO CA
94118-2358
US

V. Phone/Fax

Practice location:
  • Phone: 888-246-3333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: