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General NPI Number Information
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NPI Number | 1306051131
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Entity Type | Individual
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Provider Name | KAEWCHAI YUDANG FNP
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 1500 FLORIDA AVE
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City | MODESTO
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State | CA
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Zip | 95350-4408
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Country | US
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Telephone | 209-722-4842
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Fax |
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Provider Business Mailing Address
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Address Line | 737 W CHILDS AVE
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City | MERCED
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State | CA
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Zip | 95341-6805
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Country | US
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Telephone | 209-722-4842
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10549
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10549
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 10549
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License Number State | CA
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