Individual
DOUANGCHAY JUDY PHANGRATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4361 LATHAM ST STE 270, RIVERSIDE, CA 92501-4332
(559) 285-5946
Mailing address
7197 W SCOTT AVE, FRESNO, CA 93723-9397
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95009072
CA
Other
Enumeration date
05/24/2018
Last updated
06/11/2021
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