Healthcare Provider Details

I. General information

NPI: 1295698629
Provider Name (Legal Business Name): CHONG HER XIONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 VILLA AVE STE 28
CLOVIS CA
93612-7604
US

IV. Provider business mailing address

516 VILLA AVE STE 28
CLOVIS CA
93612-7604
US

V. Phone/Fax

Practice location:
  • Phone: 559-770-9222
  • Fax:
Mailing address:
  • Phone: 559-770-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1744G0900X
TaxonomyGraphics Designer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: