Provider Demographics
NPI:1720075914
Name:NOGALES-CHAPMAN, JUDY JOANNE (PA-C)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:JOANNE
Last Name:NOGALES-CHAPMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1460 BANCROFT WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1940
Mailing Address - Country:US
Mailing Address - Phone:510-843-5720
Mailing Address - Fax:
Practice Address - Street 1:22101 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-7107
Practice Address - Country:US
Practice Address - Phone:510-582-4700
Practice Address - Fax:510-582-7302
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17608363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical