Healthcare Provider Details

I. General information

NPI: 1689110322
Provider Name (Legal Business Name): CYNTHIA HO YAN LEUNG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 MEMORIAL DR
CERES CA
95307-1827
US

IV. Provider business mailing address

737 W CHILDS AVE
MERCED CA
95341-6805
US

V. Phone/Fax

Practice location:
  • Phone: 209-538-1096
  • Fax: 209-538-1099
Mailing address:
  • Phone: 209-384-6493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95006027
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95053114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: