Provider Demographics
NPI:1649805094
Name:CHATHA, SHAWN SINGH (FNP-C)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:SINGH
Last Name:CHATHA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10822 S CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93725-9103
Mailing Address - Country:US
Mailing Address - Phone:559-313-6697
Mailing Address - Fax:
Practice Address - Street 1:2357 W. TAHOE AVE
Practice Address - Street 2:
Practice Address - City:CARUTHERS
Practice Address - State:CA
Practice Address - Zip Code:93609
Practice Address - Country:US
Practice Address - Phone:559-864-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily