Provider Demographics
NPI:1922196401
Name:SAENG-INH, CHANPHEN (FNP)
Entity Type:Individual
Prefix:
First Name:CHANPHEN
Middle Name:
Last Name:SAENG-INH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 STRAWBERRY DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-8416
Mailing Address - Country:US
Mailing Address - Phone:559-917-5508
Mailing Address - Fax:209-384-9300
Practice Address - Street 1:3389 G ST STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-0982
Practice Address - Country:US
Practice Address - Phone:209-383-7441
Practice Address - Fax:209-383-1643
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 15724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP 15724OtherNP LICENSE