Healthcare Provider Details

I. General information

NPI: 1851295331
Provider Name (Legal Business Name): CHAU HOANG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HAWTHORNE AVE
OAKLAND CA
94609-3108
US

IV. Provider business mailing address

6520 LONETREE BLVD # 2009
ROCKLIN CA
95765-5874
US

V. Phone/Fax

Practice location:
  • Phone: 510-655-4000
  • Fax:
Mailing address:
  • Phone: 530-220-3094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA68821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: