| Doctor Name: | TINGTING JIANG |
| NPI Number: | 1174920060 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 95001463 |
| Business Practice Address: | 8101 Greenback Lane Fair Oaks, CA - 956271098 |
| Business Phone Number: | 9167264466 |
| Business Fax Number: | |
| Mailing Address: | 1600 Response Rd Apt 3023, SACRAMENTO |
| State: | CA |
| Postal Code: | 958154857 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2014 |
| NPI Last Update Date: | 06/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 95001463 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |