Provider Demographics
NPI:1497287601
Name:KAO, CHIENWEN JENNIFER
Entity type:Individual
Prefix:
First Name:CHIENWEN
Middle Name:JENNIFER
Last Name:KAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-3928
Mailing Address - Country:US
Mailing Address - Phone:401-688-0996
Mailing Address - Fax:
Practice Address - Street 1:700 EL CAMINO REAL STE 120
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4884
Practice Address - Country:US
Practice Address - Phone:650-485-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY32915103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical