Healthcare Provider Details

I. General information

NPI: 1790525251
Provider Name (Legal Business Name): SIMING CHEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8510 BALBOA BLVD STE 150
NORTHRIDGE CA
91325-5810
US

IV. Provider business mailing address

8510 BALBOA BLVD STE 150
NORTHRIDGE CA
91325-5810
US

V. Phone/Fax

Practice location:
  • Phone: 818-654-3400
  • Fax: 818-933-0525
Mailing address:
  • Phone: 818-654-3400
  • Fax: 818-933-0525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022958
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: