Provider Demographics
NPI:1831465038
Name:CHUNG, KWAI YING (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:KWAI
Middle Name:YING
Last Name:CHUNG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-2501
Mailing Address - Country:US
Mailing Address - Phone:408-988-8581
Mailing Address - Fax:408-988-8734
Practice Address - Street 1:1871 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2501
Practice Address - Country:US
Practice Address - Phone:408-988-8581
Practice Address - Fax:408-988-8734
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily