Healthcare Provider Details

I. General information

NPI: 1558615369
Provider Name (Legal Business Name): MEUY TSOON SAECHAO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 BUENAVENTURA BLVD
REDDING CA
96001-3700
US

IV. Provider business mailing address

PO BOX 496084
REDDING CA
96049-6084
US

V. Phone/Fax

Practice location:
  • Phone: 530-225-8500
  • Fax: 530-246-4000
Mailing address:
  • Phone: 530-225-8500
  • Fax: 530-246-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberFNP21795
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: