MEDICARE: DR. CHERI DIJAMCO WU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A150999	CA
2	2084P0804X	Child & Adolescent Psychiatry Physician	A150999	CA

General Provider Information

NPI Number	:	1356703045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERI DIJAMCO WU M.D.

Provider Business Mailing Address
First Line	:	2445 AUGUSTINE DR STE 150
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-3032
Country	:	US
Telephone Number	:	650-690-2070
Fax Number	:	413-304-3831

Provider Business Practice Location Address
First Line	:	2445 AUGUSTINE DR STE 150
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-3032
Country	:	US
Telephone Number	:	650-690-2070
Fax Number	:	413-304-3831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	01/16/2024

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