Provider Demographics
NPI:1992801930
Name:YIN, TERESA LI-HWA (DC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LI-HWA
Last Name:YIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:YIN
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:39210 STATE STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1456
Mailing Address - Country:US
Mailing Address - Phone:510-793-6302
Mailing Address - Fax:510-793-6305
Practice Address - Street 1:39210 STATE STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1456
Practice Address - Country:US
Practice Address - Phone:510-793-6302
Practice Address - Fax:510-793-6305
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26830111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0268300Medicare PIN
CAU80251Medicare UPIN