Provider Demographics
NPI:1285152173
Name:CHANG, CYDNI (DPT)
Entity type:Individual
Prefix:
First Name:CYDNI
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CYDNI
Other - Middle Name:
Other - Last Name:MATSUOKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:272 CARNEGIE AVE APT 147
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4185
Mailing Address - Country:US
Mailing Address - Phone:916-812-7332
Mailing Address - Fax:
Practice Address - Street 1:272 CARNEGIE AVE APT 147
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4185
Practice Address - Country:US
Practice Address - Phone:916-812-7332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0436562251X0800X
CA293617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic