Active NPI
Chenyuan Wang
- Registered Dietitian
- Sunnyvale, CA
National Provider Identifier
1104458587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86097712
- Practice address
- 120 San Lucar CT
Sunnyvale, CA 94086-5213 - Phone
- (855) 816-7705
- NPI assigned
- Feb 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86097712 | NY | Primary |
Addresses
Primary practice location
120 San Lucar CT
Sunnyvale, CA 94086-5213
Mailing address
4407 Irisview PL
San Ramon, CA 94582-5412
Phone (917) 528-9141
Other practice location 1
325 5th Ave Apt 24A
New York, NY 10016-5042
Phone (917) 528-9141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86097712 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1104458587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4407 IRISVIEW PL",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945825412",
"telephone_number": "917-528-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 SAN LUCAR CT",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940865213",
"telephone_number": "855-816-7705"
}
],
"practiceLocations": [
{
"address_1": "325 5th Ave Apt 24A",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100165042",
"country_code": "US",
"telephone_number": "917-528-9141",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WANG",
"first_name": "CHENYUAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-04",
"last_updated": "2020-09-16",
"certification_date": "2020-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86097712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.