Healthcare Provider Details

I. General information

NPI: 1124307491
Provider Name (Legal Business Name): MS. CHIA CHEN WU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE WU OTR/L

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5926 CAMELLIA AVE APT J
TEMPLE CITY CA
91780-2004
US

IV. Provider business mailing address

233 ORANGEFAIR MALL
FULLERTON CA
92832-3038
US

V. Phone/Fax

Practice location:
  • Phone: 626-616-5423
  • Fax:
Mailing address:
  • Phone: 714-870-6116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number9440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: