Provider Demographics
NPI:1003428673
Name:ZHANG, GEREMY (DNP, PHMNP-BC)
Entity type:Individual
Prefix:
First Name:GEREMY
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:DNP, PHMNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W 7TH ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3423
Mailing Address - Country:US
Mailing Address - Phone:310-430-7324
Mailing Address - Fax:310-430-7324
Practice Address - Street 1:811 W 7TH ST STE 1200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3423
Practice Address - Country:US
Practice Address - Phone:310-430-7324
Practice Address - Fax:310-430-7324
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA832693163W00000X
CA95025349363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse