Healthcare Provider Details

I. General information

NPI: 1912734567
Provider Name (Legal Business Name): CHELSEA MCGINNIS RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA BARTLETT RN, NP

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 E GARRY AVE
SANTA ANA CA
92705-5814
US

IV. Provider business mailing address

11609 MURPHY ST
LOMA LINDA CA
92354-3621
US

V. Phone/Fax

Practice location:
  • Phone: 949-807-8926
  • Fax:
Mailing address:
  • Phone: 951-206-9958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95008191
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number824290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: