Provider Demographics
NPI:1073753000
Name:JANG, CECILIA JEANNY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:JEANNY
Last Name:JANG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 MERCY AVE
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8319
Mailing Address - Country:US
Mailing Address - Phone:408-386-7142
Mailing Address - Fax:
Practice Address - Street 1:333 MERCY AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8319
Practice Address - Country:US
Practice Address - Phone:209-564-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20183363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical