Provider Demographics
NPI:1609492123
Name:BACHMAN, CHANTEL (FNP)
Entity Type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHANTEL
Other - Middle Name:
Other - Last Name:BACHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1616 DA VINCI CT
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-4860
Mailing Address - Country:US
Mailing Address - Phone:760-327-7900
Mailing Address - Fax:
Practice Address - Street 1:1616 DA VINCI CT
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-4860
Practice Address - Country:US
Practice Address - Phone:530-752-1281
Practice Address - Fax:530-754-5621
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily