Healthcare Provider Details

I. General information

NPI: 1275921223
Provider Name (Legal Business Name): VON HOANG FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2014
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LENNON LN
WALNUT CREEK CA
94598
US

IV. Provider business mailing address

500 LENNON LN
WALNUT CREEK CA
94598-2415
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-9610
  • Fax: 925-939-9630
Mailing address:
  • Phone: 925-939-9610
  • Fax: 925-939-9630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number836384
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: