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General NPI Number Information
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NPI Number | 1770240434
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Entity Type | Individual
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Provider Name | JACQUELINE BAYADING CHAN
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Gender | Female
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Dates
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Enumeration Date | 11/17/2021
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 4312 WOODMAN AVE STE 300
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-5514
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Country | US
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Telephone | 818-922-2129
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Fax | 818-922-2025
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Provider Business Mailing Address
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Address Line | 20639 LEMMER ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-4502
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Country | US
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Telephone | 818-519-6072
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Fax | 818-782-7320
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95017629
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License Number State | CA
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