Provider Demographics
NPI:1467645697
Name:CHING, NATASHA ANN (RN)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:ANN
Last Name:CHING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31039 CHALDON CIR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6923
Mailing Address - Country:US
Mailing Address - Phone:951-699-5395
Mailing Address - Fax:951-676-4298
Practice Address - Street 1:31039 CHALDON CIR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6923
Practice Address - Country:US
Practice Address - Phone:951-699-5395
Practice Address - Fax:951-676-4298
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389598163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEPS015190Medicaid
CARVN003500Medicaid