Yinchen Jenny Chen Wildman, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86020612 Issued in CA

Practice address

2472 Vista Grande
Fairfield, CA 94534-7507

Phone

(574) 323-0619

NPI assigned

Sep 25, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jenny Chen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1558188995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 VISTA GRANDE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347507",
            "telephone_number": "574-323-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2472 VISTA GRANDE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347507",
            "telephone_number": "574-323-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN WILDMAN",
        "first_name": "YINCHEN",
        "middle_name": "JENNY",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86020612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "CHEN",
            "credential": "RDN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kaylee Ann Chavarria, DPT
• Marlene Griselda Chavez Cuevas
• Elena Rayne Chavez
• Salvador Chavez
• Chen & Su Dental Group, Inc.
• Frank J Chen, D.D.S.
• Julie Ann Chen, M.D.
• William T. Chen, MD
• Cheng Zhu DMD Dental Group Inc
• Trina Cheng, PHARMD

• Registered Dietitian in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.