Provider Demographics
NPI:1720551385
Name:CHOW WONG, FRIEDA (RN)
Entity Type:Individual
Prefix:
First Name:FRIEDA
Middle Name:
Last Name:CHOW WONG
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 1:16703 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5203
Mailing Address - Country:US
Mailing Address - Phone:562-866-9011
Mailing Address - Fax:562-866-3287
Practice Address - Street 1:16703 CLARK AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5203
Practice Address - Country:US
Practice Address - Phone:562-866-9011
Practice Address - Fax:562-866-3287
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA531393163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty