Doctor Name: | LIA YOON |
NPI Number: | 1114356615 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, RN, FNP-C |
License Number: | 23732 |
Business Practice Address: | 500 Alfred Nobel Dr Suite 255a Hercules, CA - 945471838 |
Business Phone Number: | 5154193531 |
Business Fax Number: | |
Mailing Address: | 500 Alfred Nobel Dr, Suite 255a HERCULES |
State: | CA |
Postal Code: | 945471838 |
Phone Number: | 5154193531 |
Fax Number: | |
NPI Enumeration Date: | 11/05/2013 |
NPI Last Update Date: | 02/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 23732 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |