Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 14322 | CA |
NPI | 1013220938 |
---|---|
Provider Name | Jenny L. Yoon |
First Address | Simi Valley, CA 93065-7357 |
Second Address | Pacoima, CA 91331-1626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2010 |
Last Update Date | 20/07/2010 |