Provider Demographics
NPI:1841406139
Name:CHALON, JACE HAYLINGS (RN, PHN)
Entity Type:Individual
Prefix:
First Name:JACE
Middle Name:HAYLINGS
Last Name:CHALON
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0425
Mailing Address - Country:US
Mailing Address - Phone:707-502-8179
Mailing Address - Fax:
Practice Address - Street 1:317 2ND ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0425
Practice Address - Country:US
Practice Address - Phone:707-502-8179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN692718163WC1500X, 364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health