Provider Demographics
NPI:1295038503
Name:CHANG, LORINDA YU FANG (NP-C, ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LORINDA
Middle Name:YU FANG
Last Name:CHANG
Suffix:
Gender:F
Credentials:NP-C, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 STOCKTON BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:916-804-1320
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD FL 4
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-703-2085
Practice Address - Fax:916-561-7529
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 20257363L00000X
CANP20257363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner