DR. JACLYN CHUA (NPI# 1982083366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982083366 |
| Entity Type | Individual |
| Full Name | DR. JACLYN CHUA |
| Credential | D.O. |
| Practice Address |
3440 Market St Ste 200 Philadelphia PA 19104-3336 |
| Mailing Address |
1363 N 31st St Apt 302 Philadelphia PA 19121-4562 |
| Practice Telephone | 2674269799 |
| Mailing Telephone | 8622429282 |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2020-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
OS019975 | PA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
3440 MARKET ST STE 200 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-3336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063981181 | Anne Kearney | Registered Nurse | 3440 Market St Ste 200, Philadelphia, PA 19104-3336 | 2018-11-19 |
| 1356827992 | Anne Charette Vanasse | Social Worker | 3440 Market St Ste 200, Philadelphia, PA 19104-3336 | 2018-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902440621 | Eastern Pennsylvania Physician Alliance LLC | Psychiatry & Neurology | 4641 E Roosevelt Blvd, Philadelphia, PA 19124-2343 | 2019-11-06 |
| 1295175602 | Grace Unsal | Psychiatry & Neurology | Belmont Behavioral Hospital, LLC, 4200 Monument Road, Philadelphia, PA 19131 | 2013-06-29 |
| 1437463783 | Gordon R. Hodas | Psychiatry & Neurology | 8104 Germantown Ave, Philadelphia, PA 19118-3423 | 2010-07-28 |
| 1063731388 | Marc A. Forman | Psychiatry & Neurology | 233 S. 6th St, Philadelphia, PA 19106-3756 | 2010-05-26 |
| 1578723839 | Thomas Jefferson University Psych | Psychiatry & Neurology | 833 Chestnut St Ste 630, Philadelphia, PA 19107-4416 | 2008-06-11 |
| 1346464880 | Manely Ghaffari | Psychiatry & Neurology | 129 N 4th St, Office 1f, Philadelphia, PA 19106-1817 | 2007-04-13 |
| 1700954922 | Neurology Associates Ltd | Psychiatry & Neurology | 1514 Wolf St, Philadelphia, PA 19145-4441 | 2006-12-04 |
| 1912088667 | Linda Diane Gordon | Psychiatry & Neurology | 801 Market Street, Community Behavioral Health, 7th Floor, Philadelphia, PA 19107 | 2006-10-18 |
| 1821182726 | Katie L. Hoeveler | Psychiatry & Neurology | 3440 Market Street, 4th Floor, The Children's Hospital of Philadelphia, Philadelphia, PA 19104 | 2006-10-03 |
| 1235169897 | Aurora M Casta | Psychiatry & Neurology | 133 S 36th St, Philadelphia, PA 19104-3201 | 2006-07-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on DR. JACLYN CHUA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.