Healthcare Provider Details

I. General information

NPI: 1376426502
Provider Name (Legal Business Name): AMBER ELAINE CHEUNG ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17595 HARVARD AVE STE C10025
IRVINE CA
92614-8516
US

IV. Provider business mailing address

17595 HARVARD AVE STE C10025
IRVINE CA
92614-8516
US

V. Phone/Fax

Practice location:
  • Phone: 949-478-2864
  • Fax:
Mailing address:
  • Phone: 949-478-2864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95034486
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95034486
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95034486
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: