Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 292920 | CA |
N | 225100000X | Physical Therapist | 2994 | NV |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2994 | NV |
NPI | 1164880464 |
---|---|
Provider Name | Shane Yap |
First Address | Las Vegas, NV 89148-2404 |
Second Address | Menlo Park, CA 94025-3653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2016 |
Last Update Date | 08/07/2019 |