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MS. CHALICE ANN ADDIS FNP-BC

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1306359146

Individual Registrant:
MS. CHALICE ANN ADDIS FNP-BC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
141 SANDCASTLE  ALISO VIEJO, CA 92656-3817 US
Tel: 949-637-0733  Fax: --

Contact information for business:
23181 VERDUGO DR  LAGUNA HILLS, CA 92653-1357 US
Tel: 949-366-1053  Fax: 949-916-7710

Registration Information:
NPI: 1306359146
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
CANP95007969

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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