Provider Demographics
NPI:1992318224
Name:CHIN, REBECCA CHENG-JU (DPT, PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CHENG-JU
Last Name:CHIN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CHENG-JU
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3230 E IMPERIAL HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-6735
Mailing Address - Country:US
Mailing Address - Phone:714-988-8110
Mailing Address - Fax:714-988-8111
Practice Address - Street 1:3230 E IMPERIAL HWY STE 100
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6735
Practice Address - Country:US
Practice Address - Phone:714-988-8110
Practice Address - Fax:714-988-8111
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298803225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist