Provider Demographics
NPI:1548667751
Name:CHIU, WENDY (DPT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CHIU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:KUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:3425 LEBON DR APT 513
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5241
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:344 F ST STE 300
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2647
Practice Address - Country:US
Practice Address - Phone:619-585-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT42002225100000X
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist