Healthcare Provider Details

I. General information

NPI: 1821541178
Provider Name (Legal Business Name): KRISTI L. CHEN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E AVENUE I
LANCASTER CA
93535
US

IV. Provider business mailing address

311 S ALMANSOR ST APT 4
ALHAMBRA CA
91801-4268
US

V. Phone/Fax

Practice location:
  • Phone: 626-319-9851
  • Fax:
Mailing address:
  • Phone: 626-319-9851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP95003178
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberCNS4380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: