Provider Demographics
NPI:1376510743
Name:CHOW, PRISCILLA WOO (NP)
Entity Type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:WOO
Last Name:CHOW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:
Other - Last Name:CHOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:25982 PALA
Mailing Address - Street 2:STE 120
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6724
Mailing Address - Country:US
Mailing Address - Phone:949-305-2660
Mailing Address - Fax:949-305-2036
Practice Address - Street 1:23521 PASEO DE VALENCIA
Practice Address - Street 2:SUITE 311
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3107
Practice Address - Country:US
Practice Address - Phone:949-305-2660
Practice Address - Fax:949-305-2036
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA334055363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS87570Medicare UPIN
CAWNP6686CMedicare PIN