Individual provider Active NPI

Kaewchai Yudang, FNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1306051131
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
10549 Issued in CA
Practice address
1500 Florida Ave
Modesto, CA 95350-4408
Phone
(209) 722-4842
NPI assigned
May 14, 2007
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10549 CA
Family Nurse Practitioner 363LF0000X 10549 CA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 10549 CA Primary

Addresses

Primary practice location

1500 Florida Ave
Modesto, CA 95350-4408

Mailing address

737 W Childs Ave
Merced, CA 95341-6805
Phone (209) 722-4842

Other names 1

  • Kitty Puktarasiri Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050202000510 CA Practitioner - Nurse Practitioner 9234180787 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10549CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Golden Valley Health Centers CurrentSince May 7, 2023 Accepting new patients
Golden Valley Health Centers CurrentSince May 7, 2023 Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Centers Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 10, 2022 Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Permanente Medical Group Inc CurrentSince Oct 10, 2022 Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
White Memorial Medical Center Past Accepting new patients
Golden Valley Health Center Past Accepting new patients

Locations (25 of 33)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

1405 California Ave
Dos Palos, CA 93620
Phone (209) 392-2111

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

13161 Jefferson St
Le Grand, CA 95333
Phone (209) 389-1900

821 Texas Ave
Los Banos, CA 93635
Phone (209) 384-6495

250 Northgate Dr
Manteca, CA 95336
Phone (209) 239-5299

3940 Sandpiper Ave
Merced, CA 95340
Phone (209) 381-4104

737 W Childs Ave
Merced, CA 95341
Phone (209) 383-1848

797 W Childs Ave
Merced, CA 95341
Phone (209) 383-5871

847 W Childs Ave
Merced, CA 95341
Phone (209) 383-7441

1114 6th St
Modesto, CA 95354
Phone (209) 576-2845

1121 Hammond St
Modesto, CA 95351
Phone (209) 576-4437

1500 Florida Ave
Modesto, CA 95350
Phone (209) 571-5071

208 W Coolidge Ave
Modesto, CA 95350

2101 Tenaya Dr
Modesto, CA 95354
Phone (209) 527-0080

637 Merced St
Newman, CA 95360
Phone (209) 862-0270

200 C St
Patterson, CA 95363
Phone (209) 892-8441

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

3900 Lakeville Hwy
Petaluma, CA 94954
Phone (707) 765-3594

9235 E Broadway St
Planada, CA 95365
Phone (209) 382-0253

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

4150 Patterson Rd
Riverbank, CA 95367
Phone (209) 863-3900

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1306051131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 W CHILDS AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416805",
            "telephone_number": "209-722-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504408",
            "telephone_number": "209-722-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUDANG",
        "first_name": "KAEWCHAI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "10549",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "10549",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "10549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KITTY",
            "last_name": "PUKTARASIRI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.