Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | PENDING | CA |
NPI | 1023598661 |
---|---|
Provider Name | Amy Yu |
First Address | San Francisco, CA 94109-5611 |
Second Address | San Francisco, CA 94109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2018 |
Last Update Date | 14/08/2018 |