Healthcare Provider Details

I. General information

NPI: 1922196401
Provider Name (Legal Business Name): CHANPHEN SAENG-INH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3389 G ST STE B
MERCED CA
95340-0982
US

IV. Provider business mailing address

1222 STRAWBERRY DR
MERCED CA
95348-8416
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-7441
  • Fax: 209-383-1643
Mailing address:
  • Phone: 559-917-5508
  • Fax: 209-384-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 15724
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: