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NPI Code Detail

MEDICARE: ELISABETH RUIYI JIANG PMHNP

MEDICARE: ELISABETH RUIYI JIANG PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner95031500CA

General Provider Information

NPI Number : 1275364259
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISABETH RUIYI JIANG PMHNP
Provider Business Mailing Address
First Line : 740 SHELL AVE APT 302
Second Line :
City : MARTINEZ
State : CA
Zip : 94553-3235
Country : US
Telephone Number : 972-834-3176
Fax Number :
Provider Business Practice Location Address
First Line : 5201 NORRIS CANYON RD
Second Line :
City : SAN RAMON
State : CA
Zip : 94583-5411
Country : US
Telephone Number : 206-823-1004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2024
Last Update Date : 06/23/2026

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