MEDICARE: JEE HEI CHANG RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95368422	CA
2	363LF0000X	Family Nurse Practitioner	95038602	CA

General Provider Information

NPI Number	:	1174484620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEE HEI CHANG RN

Provider Business Mailing Address
First Line	:	10786 SORNOWAY LN
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-5517
Country	:	US
Telephone Number	:	510-590-6835
Fax Number	:

Provider Business Practice Location Address
First Line	:	6155 STONERIDGE DR STE 210
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-3365
Country	:	US
Telephone Number	:	925-263-9547
Fax Number	:	800-507-0849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2025
Last Update Date	:	04/08/2026

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