Healthcare Provider Details

I. General information

NPI: 1164068714
Provider Name (Legal Business Name): JANET CHENG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 12/14/2022
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3747 WORSHAM AVE STE 100
LONG BEACH CA
90808-1734
US

IV. Provider business mailing address

3747 WORSHAM AVE STE 100
LONG BEACH CA
90808-1734
US

V. Phone/Fax

Practice location:
  • Phone: 562-430-4513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95012954
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: