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General NPI Number Information
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NPI Number | 1881251403
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Entity Type | Individual
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Provider Name | CHERI VAN
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 15355 BROOKHURST ST STE 102
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City | WESTMINSTER
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State | CA
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Zip | 92683-7071
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Country | US
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Telephone | 714-531-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 10889 GOLDENEYE AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6011
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95011801
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License Number State | CA
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