Provider Demographics
NPI:1770517393
Name:CHENG, SHU-CHEN JENNIE (FNP)
Entity type:Individual
Prefix:MS
First Name:SHU-CHEN JENNIE
Middle Name:
Last Name:CHENG
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 1:8173 TANFORAN CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1089
Mailing Address - Country:US
Mailing Address - Phone:510-770-8133
Mailing Address - Fax:
Practice Address - Street 1:39500 LIBERTY ST
Practice Address - Street 2:TRI-CITY HEALTH CENTER
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2211
Practice Address - Country:US
Practice Address - Phone:510-770-8133
Practice Address - Fax:510-770-8145
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNM823363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner