Provider Demographics
NPI:1194526400
Name:JENG, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:JIA-YU
Other - Last Name:JENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18040 SHERMAN WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4656
Mailing Address - Country:US
Mailing Address - Phone:818-212-2223
Mailing Address - Fax:818-212-2224
Practice Address - Street 1:18040 SHERMAN WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4656
Practice Address - Country:US
Practice Address - Phone:818-212-2223
Practice Address - Fax:818-212-2224
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF353409-01363LF0000X
CANP95034173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily