Active NPI
Ellen Huang, PA-C, FNP
- Physician Assistant
- Fremont, CA
National Provider Identifier
1477756872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17875
- Practice address
- 39001 Sundale Dr
Fremont, CA 94538-2005 - Phone
- (510) 789-9873
- NPI assigned
- Jun 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17875 | CA | Primary |
Addresses
Primary practice location
39001 Sundale Dr
Fremont, CA 94538-2005
Mailing address
39001 Sundale Dr
Fremont, CA 94538-2005
Phone (510) 789-9873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17875 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264118400000",
"number": "1477756872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39001 SUNDALE DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382005",
"telephone_number": "510-789-9873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39001 SUNDALE DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382005",
"telephone_number": "510-789-9873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUANG",
"first_name": "ELLEN",
"name_prefix": "Miss",
"credential": "PA-C, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-06",
"last_updated": "2010-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.