Provider Demographics
NPI:1568774560
Name:CHANG, EUGENIA (MSN, RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14350 WHITTIER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2122
Mailing Address - Country:US
Mailing Address - Phone:562-696-1104
Mailing Address - Fax:562-696-2885
Practice Address - Street 1:14350 WHITTIER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2122
Practice Address - Country:US
Practice Address - Phone:562-696-1104
Practice Address - Fax:562-696-2885
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily