Provider Demographics
NPI:1639380504
Name:SAECHAO, SHOUA VANG (RN)
Entity type:Individual
Prefix:MRS
First Name:SHOUA
Middle Name:VANG
Last Name:SAECHAO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SHOUA
Other - Middle Name:
Other - Last Name:VANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1869 BROKEN BIT DRIVE
Mailing Address - Street 2:
Mailing Address - City:OLIVEHURST
Mailing Address - State:CA
Mailing Address - Zip Code:95961
Mailing Address - Country:US
Mailing Address - Phone:530-742-2982
Mailing Address - Fax:
Practice Address - Street 1:592 RIO LINDO AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1817
Practice Address - Country:US
Practice Address - Phone:530-891-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA581680163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse