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NPI Code Detail

MEDICARE: JINA CHANG

MEDICARE:   JINA  CHANG
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
1104100000XSocial Worker0903004102VA

General Provider Information

NPI Number : 1720846678
Entity Type Code : Individual
Provider Name (Legal Business Name) : JINA CHANG
Provider Business Mailing Address
First Line : 200 CROCKETT CIR APT 112
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22911-8322
Country : US
Telephone Number : 434-229-2694
Fax Number :
Provider Business Practice Location Address
First Line : 630 PETER JEFFERSON PKWY STE 130
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22911-4624
Country : US
Telephone Number : 434-201-2155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2024
Last Update Date : 03/06/2024

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Directions to “ JINA CHANG ” Practice Location

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