Provider Demographics
NPI:1871319756
Name:CHEN, TERESA YUNZI
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:YUNZI
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4355 SAINT CLOUD WAY UNIT 2
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5786
Mailing Address - Country:US
Mailing Address - Phone:917-595-0753
Mailing Address - Fax:
Practice Address - Street 1:12636 HIGH BLUFF DR STE 400
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2071
Practice Address - Country:US
Practice Address - Phone:619-762-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306981225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist