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NPI Code Detail

MEDICARE: STEPHANIE CHAN FNP-BC

MEDICARE: STEPHANIE CHAN FNP-BC
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
1363L00000XNurse PractitionerNP95033145CA

General Provider Information

NPI Number : 1477280030
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE CHAN FNP-BC
Provider Business Mailing Address
First Line : 2278 HANFORD DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-6240
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1479 YGNACIO VALLEY RD STE 150
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598-2954
Country : US
Telephone Number : 925-296-7340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2022
Last Update Date : 12/17/2025

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Directions to “ STEPHANIE CHAN FNP-BC” Practice Location

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