Jacqueline Jiaqi Chan, | |
1225 W 190th St Ste 280, Gardena, CA 90248-4305 | |
(877) 515-8113 | |
Not Available |
Full Name | Jacqueline Jiaqi Chan |
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Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 1225 W 190th St Ste 280, Gardena, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740988120 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 95126081 (California) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 95025416 (California) | Primary |
Entity Name | Affiliated Psychological Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750384350 PECOS PAC ID: 3779561378 Enrollment ID: O20040826001246 |
Entity Name | Ehab Yacoub Md Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417373713 PECOS PAC ID: 5092099523 Enrollment ID: O20170301002071 |
Mailing Address | Practice Location Address |
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Jacqueline Jiaqi Chan, 16697 Tourmaline St, Chino Hills, CA 91709-7435 Ph: () - | Jacqueline Jiaqi Chan, 1225 W 190th St Ste 280, Gardena, CA 90248-4305 Ph: (877) 515-8113 |
Starly Alvarado, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1045 W Redondo Beach Blvd Ste 300, Gardena, CA 90247 Phone: 323-241-6730 | |
Courtney Lynn Flores, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1145 W Redondo Beach Blvd, Gardena, CA 90247 Phone: 310-532-4200 | |
Selali Ziga, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 15116 S Raymond Ave Apt 106, Gardena, CA 90247 Phone: 909-576-0190 | |
Ms. Adaljiza Tavera, PMHNP, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1225 W 190th St Ste 280, Gardena, CA 90248 Phone: 310-515-8113 Fax: 310-538-2102 | |
Anna Smith, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15803 S Maple Ave, Gardena, CA 90248 Phone: 310-469-4273 | |
Angela Ugochi Otegbulu, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13812 Spinning Ave, Gardena, CA 90249 Phone: 310-529-4211 | |
Amechi Lilian Obodoagha, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1720 Marine Ave, Gardena, CA 90247 Phone: 424-263-0728 |