Provider Information

Last Updated : Nov 21 2024 4:24 PM

Gina T Chang




City
Fresno
Group
HEALTH NET DIRECT FFS MEDI-CAL
Specialty
Qualified Autism Svc Provider
Last Name
Chang
First Name
Gina
Middle Name
T
Address
6770 N West Ave Ste 105
State
CA
Zip Code
93711
Phone
(855)295-3276
Hours
Mon - Fri 8:00 AM - 5:00 PM Sat 8:00 AM - 3:00 PM
Gender
F
Physician ID
225360
Section Number
A
County
FRESNO
Accepting New Patient
Yes
PPG NAME
HEALTH NET DIRECT FFS MEDI-CAL
PPG ID
MHDML
NPI Number
1639442502
Access Requirement
Limited
PARKING_IND
P
EXT_BUILD_IND
EB
INT_BUILD_IND
IB
RESTROOM_IND
R
License ID
UNK73373
Email
credentialing@pacificchild.com
Board Certified
No
Self Access Flag
Self Reported Data
Panel Status
Available by referral only
PHY CCT IND
N

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