Provider Demographics
NPI:1629849146
Name:ZHAO, FENGNUAN
Entity Type:Individual
Prefix:
First Name:FENGNUAN
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36305 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-2365
Mailing Address - Country:US
Mailing Address - Phone:626-348-1437
Mailing Address - Fax:
Practice Address - Street 1:1141 HARBOR BAY PKWY # 105
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94502-6596
Practice Address - Country:US
Practice Address - Phone:510-835-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker