Provider Demographics
NPI:1174298095
Name:CHEN, KARLA ALEHANDRA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:ALEHANDRA
Last Name:CHEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:A
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:4347 SLAUSON AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90270-2837
Mailing Address - Country:US
Mailing Address - Phone:909-455-4128
Mailing Address - Fax:323-773-2097
Practice Address - Street 1:4347 SLAUSON AVE STE A
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-2837
Practice Address - Country:US
Practice Address - Phone:323-773-3137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95123216163W00000X
CA95019230363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily