Healthcare Provider Details

I. General information

NPI: 1831075902
Provider Name (Legal Business Name): CHUNRAN ZHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date: 04/30/2026
Reactivation Date: 07/27/2026

III. Provider practice location address

995 GATEWAY CENTER WAY SUITE 300
SAN DIEGO CA
92102
US

IV. Provider business mailing address

995 GATEWAY CENTER WAY SUITE 300
SAN DIEGO CA
92102
US

V. Phone/Fax

Practice location:
  • Phone: 619-398-2156
  • Fax:
Mailing address:
  • Phone: 619-398-2156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWIA.SC.70134387
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: