Provider Demographics
NPI:1780640649
Name:CHUEH, COLLEEN SOONG (RN)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:SOONG
Last Name:CHUEH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:CHUNG-PEI
Other - Last Name:SOONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4600 BROADWAY
Mailing Address - Street 2:SUITE #1100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1527
Mailing Address - Country:US
Mailing Address - Phone:916-874-9753
Mailing Address - Fax:916-874-9297
Practice Address - Street 1:4600 BROADWAY
Practice Address - Street 2:SUITE #1100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1527
Practice Address - Country:US
Practice Address - Phone:916-874-9753
Practice Address - Fax:916-874-9297
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA506395163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health