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MS. CHALICE ANN ADDIS FNP-BC
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1306359146
Individual Registrant:MS. CHALICE ANN ADDIS FNP-BC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
141 SANDCASTLE ALISO VIEJO, CA 92656-3817 US
Tel: 949-637-0733 Fax: --
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
Tel: 949-366-1053 Fax: 949-916-7710
Registration Information:
NPI: 1306359146
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | CA | NP95007969 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
