Provider Demographics
NPI:1003072026
Name:YU, RENA YUNI
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:YUNI
Last Name:YU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 COLLEGE TOWN DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2356
Mailing Address - Country:US
Mailing Address - Phone:916-444-0889
Mailing Address - Fax:916-444-6016
Practice Address - Street 1:7750 COLLEGE TOWN DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2356
Practice Address - Country:US
Practice Address - Phone:916-444-0889
Practice Address - Fax:916-444-6016
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110618207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1265442800Medicaid