Provider Demographics
NPI:1588723308
Name:CHENG, YI-CHUAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:YI-CHUAN
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:YI-CHUAN CATHY
Other - Middle Name:
Other - Last Name:CHENG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:2667 CAMINO DEL RIO S STE 301-3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2667 CAMINO DEL RIO S STE 301-3
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3707
Practice Address - Country:US
Practice Address - Phone:858-335-7736
Practice Address - Fax:858-335-7736
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22691103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACD041ZMedicare UPIN