Healthcare Provider Details
I. General information
NPI: 1982590816
Provider Name (Legal Business Name): JENNY HAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
731 S HIGHLAND AVE
FULLERTON CA
92832-2753
US
IV. Provider business mailing address
2000 E CHAPMAN AVE STE 100
FULLERTON CA
92831-4103
US
V. Phone/Fax
- Phone: 714-446-5100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 95035184 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: