Provider Demographics
NPI:1245778513
Name:FENG, SIO CHIN (NP)
Entity Type:Individual
Prefix:
First Name:SIO
Middle Name:CHIN
Last Name:FENG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 S BASCOM AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0638
Mailing Address - Country:US
Mailing Address - Phone:408-214-9732
Mailing Address - Fax:
Practice Address - Street 1:1760 S BASCOM AVE STE 140
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0638
Practice Address - Country:US
Practice Address - Phone:408-214-9732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95005812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily