Individual provider Active NPI

Lauren Nicole Date-Chong, PNP

  • Pediatric Nurse Practitioner
  • Valley Springs, CA
National Provider Identifier
1710518808
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95013441 Issued in CA
Practice address
51 Wellness Way
Valley Springs, CA 95252-9736
Phone
(209) 772-7070
Fax
(207) 772-1011
NPI assigned
Jan 28, 2020
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95013441 CA Primary

Addresses

Primary practice location

51 Wellness Way
Valley Springs, CA 95252-9736

Mailing address

5049 Deerpark Cir
Fair Oaks, CA 95628-4209
Phone (925) 915-9918

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
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Twain Health Care District PastSince Apr 14, 2020 Accepting new patients
NVP Medical, Inc. Past Accepting new patients
Noe Valley Pediatrics, a Medical Group, Inc. Past Accepting new patients
University of California San Francisco Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ldatechong210041@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1710518808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5049 DEERPARK CIR",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956284209",
            "telephone_number": "925-915-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 WELLNESS WAY",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952529736",
            "telephone_number": "209-772-7070",
            "fax_number": "207-772-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATE-CHONG",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95013441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.