Healthcare Provider Details

I. General information

NPI: 1689195554
Provider Name (Legal Business Name): JING JING ZHANG AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8135 PAINTER AVE # 3105
WHITTIER CA
90602-3158
US

IV. Provider business mailing address

340 W LAS FLORES AVE
ARCADIA CA
91007-8227
US

V. Phone/Fax

Practice location:
  • Phone: 562-444-5450
  • Fax: 626-540-0361
Mailing address:
  • Phone: 626-644-7906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95006838
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95006838
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: