Healthcare Provider Details

I. General information

NPI: 1780103473
Provider Name (Legal Business Name): WEIYAN ZHENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 BLUFFSTONE CV STE A201
AUSTIN TX
78759-7846
US

IV. Provider business mailing address

4175 BIDWELL DR
FREMONT CA
94538-2612
US

V. Phone/Fax

Practice location:
  • Phone: 800-967-4667
  • Fax:
Mailing address:
  • Phone: 669-666-0964
  • 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
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: