Healthcare Provider Details

I. General information

NPI: 1619315215
Provider Name (Legal Business Name): CHUE XIONG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 CYPRESS AVE
CARMICHAEL CA
95608-2112
US

IV. Provider business mailing address

5410 CYPRESS AVE
CARMICHAEL CA
95608-2112
US

V. Phone/Fax

Practice location:
  • Phone: 530-867-5866
  • Fax:
Mailing address:
  • Phone: 530-867-5866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: