Healthcare Provider Details

I. General information

NPI: 1598142309
Provider Name (Legal Business Name): HELEN CHEUNG PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AN AN WANG

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5545 T ST
SACRAMENTO CA
95819-4844
US

IV. Provider business mailing address

1133 W SACRAMENTO AVE APT 20
CHICO CA
95926-4350
US

V. Phone/Fax

Practice location:
  • Phone: 608-695-6710
  • Fax:
Mailing address:
  • Phone: 608-695-6710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA62537
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number192828-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: