Healthcare Provider Details

I. General information

NPI: 1306320841
Provider Name (Legal Business Name): MRS. TUC QUYEN CHAPPELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 2300
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 2300
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2737
  • Fax:
Mailing address:
  • Phone: 916-734-2737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95009018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: