Healthcare Provider Details

I. General information

NPI: 1861312167
Provider Name (Legal Business Name): NADIA ALEXANDRA CHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 WILLOW PASS RD STE 700
CONCORD CA
94520-7926
US

IV. Provider business mailing address

1463 BALHAN DR APT 106
CONCORD CA
94521-3752
US

V. Phone/Fax

Practice location:
  • Phone: 925-293-2781
  • Fax:
Mailing address:
  • Phone: 415-755-7105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number220160058
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: